Journal of thrombosis and haemostasis : JTH · 2026
Prevalence and outcomes of antiphospholipid syndrome after unprovoked venous thromboembolism: a multicenter real-world data analysis.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Mathur Abhinav, Cox Catrin, Banerjee Shabnam, Rees Marilyn, Roberts Lara, Breen Karen A, Lentaigne Claire, Alikhan Raza, Doyle Andrew J, Khan Mohammed M
Аннотация
BACKGROUND: Guidance for antiphospholipid antibody (aPL) testing after unprovoked venous thromboembolism (VTE) is inconsistent. Real-world data on the prevalence and outcomes of antiphospholipid syndrome (APS) in those presenting with unprovoked VTE are limited.
OBJECTIVES: This study determined APS prevalence after unprovoked VTE, compared outcomes from universal vs selective aPL testing, and assessed thrombosis recurrence in patients with APS within a multicenter UK cohort.
METHODS: This retrospective analysis included 897 patients with unprovoked VTE from 5 UK centers. One center used universal (n = 533) and 4 used selective (n = 364) aPL testing. The primary outcome was APS prevalence. Secondary outcomes included thrombosis-free survival by testing strategy and by anticoagulant (direct oral anticoagulants vs vitamin K antagonists) in patients with APS.
RESULTS: The overall APS prevalence was 11.7% and was higher in the universal testing than in the selective cohort (15.8% vs 5.8%). Baseline clinical features were poor predictors of APS. Among 105 patients with APS (median follow-up, 4.2 years), the annual thrombotic recurrence rate was 2.1 per 100 person-years. A nonsignificant trend toward higher recurrence was observed over time for direct oral anticoagulants vs vitamin K antagonists (3.8 vs 1.3 events/100 person-years; P = .16). No thrombosis-free survival difference was found between testing strategies (P = .71).
CONCLUSION: The prevalence of APS following unprovoked VTE is notable, and selective testing identified fewer APS cases in practice. Identifying aPLs in patients with unprovoked VTE may inform discussions regarding anticoagulation duration and choice, although optimal testing strategies require further prospective evaluation.
OBJECTIVES: This study determined APS prevalence after unprovoked VTE, compared outcomes from universal vs selective aPL testing, and assessed thrombosis recurrence in patients with APS within a multicenter UK cohort.
METHODS: This retrospective analysis included 897 patients with unprovoked VTE from 5 UK centers. One center used universal (n = 533) and 4 used selective (n = 364) aPL testing. The primary outcome was APS prevalence. Secondary outcomes included thrombosis-free survival by testing strategy and by anticoagulant (direct oral anticoagulants vs vitamin K antagonists) in patients with APS.
RESULTS: The overall APS prevalence was 11.7% and was higher in the universal testing than in the selective cohort (15.8% vs 5.8%). Baseline clinical features were poor predictors of APS. Among 105 patients with APS (median follow-up, 4.2 years), the annual thrombotic recurrence rate was 2.1 per 100 person-years. A nonsignificant trend toward higher recurrence was observed over time for direct oral anticoagulants vs vitamin K antagonists (3.8 vs 1.3 events/100 person-years; P = .16). No thrombosis-free survival difference was found between testing strategies (P = .71).
CONCLUSION: The prevalence of APS following unprovoked VTE is notable, and selective testing identified fewer APS cases in practice. Identifying aPLs in patients with unprovoked VTE may inform discussions regarding anticoagulation duration and choice, although optimal testing strategies require further prospective evaluation.