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Anti-Domain I beta(2)-Glycoprotein I Antibodies and Activated Protein C Resistance Predict Thrombosis in Antiphospholipid Syndrome
- Source :
- Journal of Applied Laboratory Medicine, 5(6), 1242-1252. American Association of Clinical Chemistry, The Journal of Applied Laboratory Medicine, The Journal of Applied Laboratory Medicine, Oxford University Press, 2020, 5 (6), pp.1242-1252. ⟨10.1093/jalm/jfaa072⟩
- Publication Year :
- 2020
-
Abstract
- Background Antibodies binding to domain I of β2-glycoprotein I (aDI) and activated protein C (APC) resistance are associated with an increased risk of thrombosis in cross-sectional studies. The objective of this study was to assess their predictive value for future thromboembolic events in patients with antiphospholipid antibodies (aPL) or antiphospholipid syndrome. Methods This prospective multicenter cohort study included consecutive patients with aPL or systemic lupus erythematosus. We followed 137 patients (43.5 ± 15.4 year old; 107 women) for a mean duration of 43.1 ± 20.7 months. Results We detected aDI IgG antibodies by ELISA in 21 patients. An APC sensitivity ratio (APCsr) was determined using a thrombin generation–based test. The APCsr was higher in patients with anti–domain I antibodies demonstrating APC resistance (0.75 ± 0.13 vs 0.48 ± 0.20, P 95th percentile; HR, 6.07 [95% CI, 1.69–21.87]; P = 0.006). A sensitivity analysis showed an increased risk of higher aDI IgG levels up to HR 5.61 (95% CI, 1.93–16.31; P = 0.01). In multivariate analysis, aDI IgG (HR, 3.90 [95% CI, 1.33–11.46]; P = 0.01) and APC resistance (HR, 4.98 [95% CI, 1.36–18.28]; P = 0.02) remained significant predictors of thrombosis over time. Conclusions Our study shows that novel tests for antibodies recognizing domain I of β2-glycoprotein I and functional tests identifying APC resistance are significant predictors of thrombosis over time and may be useful for risk stratification.
- Subjects :
- medicine.medical_specialty
[SDV]Life Sciences [q-bio]
1ST EPISODE
030204 cardiovascular system & hematology
Gastroenterology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Antiphospholipid syndrome
Internal medicine
medicine
Humans
CLASSIFICATION CRITERIA
Prospective Studies
Activated Protein C Resistance
LUPUS ANTICOAGULANTS
030203 arthritis & rheumatology
RISK
Lupus anticoagulant
REVISED CRITERIA
biology
business.industry
RECOGNIZE
Thrombosis
General Medicine
ASSOCIATION
STANDARDIZATION
medicine.disease
Antiphospholipid Syndrome
Cross-Sectional Studies
beta 2-Glycoprotein I
biology.protein
Female
AUTOANTIBODIES
Activated protein C resistance
Antibody
business
Protein C
β2 glycoprotein i
Cohort study
medicine.drug
GENERATION
Subjects
Details
- Language :
- English
- ISSN :
- 25769456
- Volume :
- 5
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of Applied Laboratory Medicine
- Accession number :
- edsair.doi.dedup.....7c73030bb951180ec3b0f0e156898622