Increased risk of vascular complications in Takayasu's arteritis patients with positive lupus anticoagulant

• Published in: Scandinavian journal of rheumatology Vol. 44; no. 3; pp. 211 - 214
• Main Authors: Jordan, NP, Bezanahary, H, D'Cruz, DP
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.05.2015
• Subjects: Adult; Antibodies, Anticardiolipin - immunology; Anticoagulants - therapeutic use; Antiphospholipid Syndrome - complications; Aortic Valve - surgery; Bicuspid Aortic Valve Disease; Carotid Artery Diseases - etiology; Coronary Artery Disease - etiology; Enzyme-Linked Immunosorbent Assay; Female; Femoral Artery; Heart Defects, Congenital - etiology; Heart Defects, Congenital - surgery; Heart Valve Diseases - etiology; Heart Valve Diseases - surgery; Heart Valve Prosthesis Implantation; Humans; Immunoglobulin G - immunology; Immunoglobulin M - immunology; Immunosuppressive Agents - therapeutic use; Ischemic Attack, Transient - etiology; Kidney Failure, Chronic - etiology; Lupus Coagulation Inhibitor - immunology; Male; Middle Aged; Peripheral Arterial Disease - etiology; Renal Artery; Retrospective Studies; Risk Factors; Stroke - etiology; Takayasu Arteritis - complications; Takayasu Arteritis - drug therapy; Takayasu Arteritis - immunology; Vision Disorders - etiology; Young Adult
• ISSN: 0300-9742; 1502-7732
• DOI: 10.3109/03009742.2014.964305

Objectives: Previous studies have shown antiphospholipid antibodies (aPL) to be prevalent in primary systemic vasculitides; however, the possible clinical impact of aPL positivity in such patients has not been explored in depth. The aims of this study were to determine the prevalence of aPL in patients with Takayasu's arteritis (TA) and to ascertain whether aPL positivity was predictive of a worse clinical outcome in TA. Method: Clinical data were collected retrospectively on 22 TA patients over an 11-year period. Data collected included the presence of lupus anticoagulant (LA) and immunoglobulin (Ig)G and IgM anticardiolipin antibody (aCL) titres. Adverse clinical outcomes included cerebrovascular accident (CVA), transient ischaemic attack (TIA), loss of vision, vascular lesions (carotid, femoral, renal, coronary, or other vessels) requiring stenting, angioplasty, or other surgical intervention, aortic valve replacement, end-stage renal failure or death. Results: Persistently positive aPL or a concurrent diagnosis of antiphospholipid syndrome (APS) was found in 45% (n = 10) of TA patients while 55% (n = 12) had TA alone. LA was present in a significant proportion of TA patients with aPL (p = 0.002). Vascular complications occurred in 70% (n = 7) of TA patients with aPL and in 25% (n = 3) of TA patients without aPL (p = 0.035). LA was associated with a higher prevalence of vascular complications. Conclusions: Persistently positive aPL are present in a significant proportion of TA patients. This study shows that vascular complications and need for intervention are more prevalent in TA patients with aPL, particularly those with LA. Prospective studies are needed to determine the long term prognosis in such patients.