دورية أكاديمية
Precipitating factors of catastrophic antiphospholipid syndrome: the role of anticoagulant treatment in a series of 112 patients.
| العنوان: | Precipitating factors of catastrophic antiphospholipid syndrome: the role of anticoagulant treatment in a series of 112 patients. |
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| المؤلفون: | Stammler, Romain, Nguyen, Yann, Yelnik, Cécile, Le Guern, Véronique, Lambert, Marc, Paule, Romain, Hachulla, Eric, Mouthon, Luc, Dupré, Anastasia, Ackermann, Félix, Dufrost, Virginie, Wahl, Denis, Godeau, Bertrand, Leroux, Gaëlle, Benhamou, Ygal, Lazaro, Estibaliz, Daugas, Eric, Bezanahary, Holy, Mekinian, Arsène, Piette, Jean-Charles, Morel, Nathalie |
| المساهمون: | Université de Lille, Inserm, CHU Lille, Institut Cochin IC UM3 (UMR 8104 / U1016), Centre de référence des maladies auto-immunes systémiques rares d'Île-de-France / National Reference Center for Rare Systemic Autoimmune Diseases, Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 RID-AGE, Hôpital Cochin AP-HP, Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167, Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286, Hôpital Foch Suresnes, Centre Hospitalier Régional Universitaire de Nancy CHRU Nancy, Centre d'Investigation Clinique Henri Mondor CIC Henri Mondor, Immunologie - Immunopathologie - Immunothérapie CHU Pitié Salpêtrière I3, CHU Bordeaux, AP-HP - Hôpital Bichat - Claude Bernard Paris, Service de Médecine interne A et polyclinique médicale CHU Limoges, Centre de Recherche Saint-Antoine CRSA |
| سنة النشر: | 2024 |
| المجموعة: | LillOA (Lille Open Archive - Université de Lille) |
| مصطلحات موضوعية: | anticoagulant, antiphospholipid antibodies, antiphospholipid syndrome, autoimmune diseases, catastrophic antiphospholipid syndrome |
| الوصف: | Background The prevention of catastrophic antiphospholipid syndrome (CAPS), a rare complication of antiphospholipid syndrome (APS), is a major goal. Objectives We analyzed its precipitating factors, focusing on anticoagulation immediately before CAPS episodes. Methods We retrospectively analyzed patients in the French multicenter APS/systemic lupus erythematosus database with at least 1 CAPS episode. Then we compared each patient with known APS before CAPS with 2 patients with non-CAPS APS matched for age, sex, center, and APS phenotype. Results We included 112 patients with CAPS (70% women; mean age, 43 ± 15 years). At least 1 standard precipitating factor of CAPS was observed for 67 patients (64%), which were mainly infections (n = 28, 27%), pregnancy (n = 23, 22%), and surgery (n = 16, 15%). Before the CAPS episode, 67 (60%) patients already had a diagnosis of APS. Of the 61 treated with anticoagulants, 32 (48%) received vitamin K antagonists (VKAs), 23 (34%) heparin, and 2 (3%) a direct oral anticoagulant. They were less likely than their matched patients with APS without CAPS to receive VKA (48% vs 66%, p = .001). Among those treated with VKA, 72% had a subtherapeutic international normalized ratio (ie, <2) versus 28% in patients with APS without CAPS (p < .001). Finally, excluding pregnant patients (n = 14) for whom we could not differentiate the effect of treatment from that of pregnancy, we were left with 47 cases, 32 (68%) of whom had recently begun a direct oral anticoagulant, planned bridging therapy, or had VKA treatment with international normalized ratio <2. Conclusion These results strongly suggest that suboptimal anticoagulation management can trigger CAPS in patients with thrombotic APS. ; 21;5 |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | 2b384f6d-2782-43c5-b1ba-af8ae77ab16f; Journal of Thrombosis and Haemostasis; http://hdl.handle.net/20.500.12210/100630Test |
| الإتاحة: | https://doi.org/20.500.12210/100630Test https://hdl.handle.net/20.500.12210/100630Test |
| حقوق: | info:eu-repo/semantics/closedAccess |
| رقم الانضمام: | edsbas.8BF40516 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |