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Clin Exp Rheumatol. 2013 May-Jun;31(3):382-8. Epub 2013 Jan 10.

The role of lupus anticoagulant and triple marker positivity as risk factors for rethrombosis in patients with primary antiphospholipid syndrome.

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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.



To ascertain rethrombotic risk factors in patients with primary antiphospholipid syndrome (PAPS).


We retrospectively evaluated 95 patients according to their rethrombotic status. We registered anticoagulation (OA) status, comorbidities, traditional thrombotic factors, prevalence of aCL (IgG-IgM), anti-β2GP-I (IgG-IgM), LA and triple marker positivity (LA, aCL and anti-β2GP-I).


Forty-two patients had rethrombosis and 53 were rethrombosis-free. The median follow-up was 4.5 (0.3-26) years. There were no differences in comorbidities and traditional thrombotic factors. Patients with rethrombosis had more frequently LA (62% vs. 40%, p=0.04), were younger (41 vs. 47 years, p=0.01) and received less frequently OA (23% vs. 54%, p=0.002). A logistic regression analysis showed that the OA status (OR 0.17, 95% CI 0.05-0.57, p=0.004) and age (OR 0.94, 95% CI 0.90-0.98, p=0.01) remained significant. Patients who discontinued OA and developed rethrombosis (Group 1, n=32) vs. patients who discontinued OA, but remained rethrombosis-free (Group 2, n=24) were also analysed. We found a higher prevalence of LA and triple marker positivity in Group 1 (67% vs. 31%; OR= 4.5, 95% CI 1.3-14.9, p= 0.01 and 57% vs. 27%; OR 3.6, 95% CI 1.7-12; p=0.03), respectively. Both variables remained associated with rethrombosis when compared with the overall rethrombosis group vs. Group 2 (LA 62% vs. 31%, OR= 3.6 95% CI 1.1-11.2, p=0.03; triple marker 54% vs. 27%; OR 32 95% CI 1.01-10.2, p=0.05).


LA positivity and triple aPL positivity confer a more severe risk of rethrombosis in PAPS patients, irrespective of their anticoagulation status and known conventional risk factors.

[Indexed for MEDLINE]

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