| Title | Anticardiolipin antibodies predict early recurrence of thromboembolism and death among patients with venous thromboembolism following anticoagulant therapy. Duration of Anticoagulation Study Group. |
| Author(s) | Schulman S, Svenungsson E, Granqvist S |
| Institution | Department of Medicine, Karolinska Hospital, Stockholm, Sweden. |
| Source | Am J Med 1998 Apr; 104(4):332-8. |
| MeSH | Aged
Antibodies, Anticardiolipin
Anticoagulants
Cause of Death
Comparative Study
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Recurrence
Research Support, Non-U.S. Gov't
Risk
Thromboembolism
|
| Abstract | PURPOSE: To compare the risk of recurrent venous thromboembolism in patients with and without antiphospholipid antibodies.
PATIENTS AND METHODS: Anticardiolipin antibodies were tested 6 months after a first or second episode of venous thromboembolism. Of the patients with a first episode of venous thromboembolism only the 412 who received 6 months of anticoagulation were studied. Two hundred and eleven patients with a second episode received oral anticoagulation for 6 months or indefinitely. The therapy was targeted at an international normalized ratio (INR) of 2.0 to 2.85. All patients were followed up for 4 years after enrollment.
RESULTS: Among the 412 patients with a first episode of venous thromboembolism the risk of recurrence was 29% in patients with anticardiolipin antibodies and 14% in those without antibodies (P = 0.0013). In those with antibodies, there was an increased risk during the first 6 months after cessation of anticoagulation. The risk of recurrence increased with the titer of the antibodies. Four-year mortality rate was 15% in those with antibodies and 6% in those without (P = 0.01). Among 34 patients with a second event of venous thromboembolism and anticardiolipin antibodies, there were no recurrences during anticoagulant therapy versus 20% in those who received only 6 months of treatment (P = 0.08).
CONCLUSIONS: The presence of elevated titers of anticardiolipin antibodies 6 months after an episode of venous thromboembolism is a predictor for an increased risk of recurrence and of death. Patients with anticardiolipin antibodies and venous thromboembolism seem to benefit from prolonged oral anticoagulation. |
| Language | eng |
| Pub Type(s) | Journal Article
Multicenter Study
|
| PubMed ID | 9576405 |
