Document Detail


High impact of antiphospholipid syndrome on irreversible organ damage and survival of patients with systemic lupus erythematosus.
MedLine Citation:
PMID:  14718326     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Thrombosis is a frequent cause of morbidity and death in patients with systemic lupus erythematosus (SLE). Whether antiphospholipid syndrome (APS) is the cause of increased irreversible organ damage and mortality in lupus patients is not well established. METHODS: Prospective inception cohort of 202 patients with SLE (American College of Rheumatology criteria). Antiphospholipid syndrome was defined according to the Sapporo criteria. Irreversible damage was measured using the Systemic Lupus International Collaborating Clinics-American College of Rheumatology damage index (SDI) at 6 months and 1, 3, 5, 10, 15, 20, and 25 years after the diagnosis of SLE. All deaths were documented. RESULTS: A total of 88% of patients were women. Twenty-eight patients met criteria for definite APS. Mean (SD) follow-up was 9.7 (6.0) years. Nine patients could not be contacted for follow-up. All patients with APS experienced thrombosis, most of them in the arterial bed. Damage was more severe in patients with APS than in those without APS (median SDI score, 2 vs 0 at 5 years; P<.001; 4 vs 1 at 15 years; P<.001). Cumulative survival at 15 years was lower in patients with APS than in those without APS (65% vs 90%, P =.03). Older age at diagnosis, lupus nephritis, and APS were independent predictors of mortality. CONCLUSIONS: Antiphospholipid syndrome with thrombotic manifestations is a major predictor of irreversible organ damage and death in patients with SLE.
Authors:
Guillermo Ruiz-Irastorza; Maria-Victoria Egurbide; Jon Ugalde; Ciriaco Aguirre
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  164     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-13     Completed Date:  2004-03-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  77-82     Citation Subset:  AIM; IM    
Affiliation:
Servicio de Medicina Interna, Hospital de Cruces, Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, Spain. r.irastorza@euskalnet.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Antiphospholipid Syndrome / complications,  mortality*
Cohort Studies
Female
Humans
Lupus Erythematosus, Systemic / complications,  mortality*
Lupus Nephritis / complications,  mortality
Male
Multiple Organ Failure / etiology,  mortality*
Proportional Hazards Models
Prospective Studies
Survival Analysis
Thrombosis / etiology,  mortality
Comments/Corrections
Comment In:
Arch Intern Med. 2004 Aug 9-23;164(15):1701; author reply 1701-2   [PMID:  15302646 ]

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