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In between 2005-2011 a study was conducted in Poznań, Poland, with the aim to find a correlation between actual APS diagnostic guidelines (criteria from Sydney’2006) and the clinical feature of thrombosis in this syndrome with coexistence of inherited thrombophilia and risk factors for cardio-vascular disease included. Additionally, a selection of the highest thromboembolic risk group was made among asymptomatic patients with antiphospholipid antibodies (APA) detected to compare with APS patients. An association between a type of laboratory test confirming the longtime APA presence and thrombotic risk was analyzed as well.
The follow up had lasted for meanly 47 months and included 75 patients (50 females and 25 males) at the mean age of 43, divided into three groups (25 persons each): I – with asymptomatic APA, IIA – with arterial episodes in the history and IIB – with past venous complications in the course of APS. The majority of them comprised persons with primary APS or with asymptomatic APA (aAPA) - without any other autoimmune diseases.
The laboratory tests included: lupus anticoagulant (LA) according to the 3-step procedure recommended by ISTH (International Society on Thrombosis and Hemostasis), anticardiolipin (ACA) – of IgG and IgM class and anti-β2-glycoprotein I (aβ 2 GPI) – of IgG class, both with the cut-off value of 99 percentile. D-dimer and fibrinogen concentration, protein C and antithrombin activity, activated protein C resistance, free protein S concentration, factor VIII were further analyzed.
Among comorbidities and risk factors for venous and arterial thrombosis, there was significantly more frequent incidence of autoimmune diseases in the asymptomatic group of people compared to patients after thromboembolic episodes.
Most often the aAPA presence was confirmed in the LA tests – the majority of positive results appeared among patients with asymptomatic course and with past venous thrombosis as well and less frequently - in the group of arterial episodes in the history.
Any significant differences were found in the reference to the incidence of thrombotic episodes in the retrospective assessment of symptomatic patients and prospective – in the whole investigated group, although the time of their occurrence after beginning of observation period almost doubled in people with past thromboembolic episodes, comparing to the earlier asymptomatic persons.
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