Increased risk of vascular complications in Takayasu's arteritis patients with positive lupus anticoagulant
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 patie...
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Published in | Scandinavian journal of rheumatology Vol. 44; no. 3; pp. 211 - 214 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
England
Informa Healthcare
01.05.2015
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Abstract | 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. |
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AbstractList | 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. OBJECTIVESPrevious 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. METHODClinical 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. RESULTSPersistently 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. CONCLUSIONSPersistently 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. 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. 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. 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. 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. |
Author | D'Cruz, DP Jordan, NP Bezanahary, H |
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Cites_doi | 10.1002/1529-0131(199907)42:7<1309::AID-ANR1>3.0.CO;2-F 10.1007/s10067-006-0277-3 10.1080/03009740510026526 10.1136/ard.2004.034231 10.1002/1529-0131(200002)43:2<440::AID-ANR26>3.0.CO;2-N 10.1002/art.1780330811 10.1002/art.22404 10.1007/s00296-005-0065-4 |
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Copyright | 2015 Taylor & Francis on license from Scandinavian Rheumatology Research Foundation 2015 2015 Informa Healthcare on license from Scandinavian Rheumatology Research Foundation 2015 |
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References | Castellino G (CIT0012) 2000 Fernandez R L F (CIT0009) 1994 Rees JD (CIT0013) 2006; 65 Santiago MB (CIT0005) 2007; 26 Handa R (CIT0011) 1999 Maksimowicz-McKinnon K (CIT0001) 2007; 56 Arend WP (CIT0007) 1990; 33 CIT0004 Morović-Vergles J. (CIT0006) 2006; 26 Lockshin MD (CIT0008) 2000; 43 Park MC (CIT0002) 2005; 34 Hughes GR (CIT0003) 1986; 13 Cohney S (CIT0010) 1995 |
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SubjectTerms | 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 |
Title | Increased risk of vascular complications in Takayasu's arteritis patients with positive lupus anticoagulant |
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