The lupus anticoagulant is a risk factor for myocardial infarction (but not atherosclerosis): Hopkins lupus cohort
The lupus anticoagulant is a risk factor for myocardial infarction (but not atherosclerosis): Hopkins lupus cohort
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DOI：
10.1016/j.thromres.2004.07.012
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发表时间：
2004-01-01
影响因子：
7.5
通讯作者：
Petri, M
中科院分区：
文献类型：
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作者：
Petri, M
抗磷脂抗体，抗心磷脂和狼疮抗凝剂，是常见的SLE。我们在一个前瞻性队列中询问这些抗体是否能预测动脉粥样硬化和/或冠状动脉疾病。研究方法：每季度随访380名患者，其中92%为女性，49%为高加索人，51%为非洲裔美国人，平均年龄46.4 ± 12.3岁，评估抗心磷脂和狼疮抗凝剂（dRVVT）。所有患者均行螺旋CT和颈动脉多普勒超声检查。结果如下：狼疮抗凝剂和抗心磷脂都是后期静脉或动脉血栓形成的预测因子。诊断后20年，狼疮抗凝剂（LA）的SLE患者有50%的机会发生静脉血栓形成事件。LA 22%的患者发生心肌梗死的频率显著高于LA 9%的患者，p=0.04。螺旋CT显示抗心磷脂和LA均与颈动脉IMT、颈动脉斑块和冠状动脉钙化无关。aCL阳性患者颈动脉IMT为0.57 +/- 0.01，aCL阴性患者为0.58 +/- 0.01（p=NS）;颈动脉斑块为0.47 +/- 0.13，aCL阴性患者为0.32 +/- 0.10（p=NS）;冠状动脉钙为65.4 +/- 37.4，aCL阴性患者为65.4 +/- 30.2（p=NS）。在LA阳性患者中，颈动脉IMT为0.59 +/- 0.03，LA阴性患者为0.59 +/- 0.02（p=NS）;颈动脉斑块为0.07 +/- 0.02（SE）vs. 0.80 +/- 0.02（SE）（p=0.06）;冠状动脉钙28.1 +/- 3.7（SE）vs. 85.7 +/- 2.6（SE）（p=NS）。结论：抗磷脂抗体与亚临床动脉粥样硬化（颈动脉IMR、颈动脉斑块、螺旋CT冠状动脉钙化）无关，但与实际血栓性后遗症（心肌梗死）相关。(c)2004爱思唯尔有限公司保留所有权利。
Antiphospholipid antibodies, both anticardiolipin and lupus anticoagulant, are common in SLE. We asked, in a prospective cohort, whether these antibodies are predictive of atherosclerosis and/or coronary artery disease. Methods: Three hundred eighty patients, 92% female, 49% Caucasian, 51% African-American, mean age 46.4 +/- 12.3 years are followed quarterly, with assessment of both anticardiolipin and Lupus anticoagulant (dRVVT). These patients underwent both helical CT and carotid duplex. Results: Both the Lupus anticoagulant and anticardiolipin are predictive of later venous or arterial thrombosis, Twenty years after diagnosis, SLE patients with the lupus anticoagulant (LA) have a 50% chance of a venous thrombotic event. Myocardial infarction occurs significantly more often in those with LA 22% vs. 9%, p=0.04. Neither anticardiolipin nor LA are associated with carotid IMT, carotid plaque, nor coronary calcium by helical CT. In aCL positive patients carotid IMT was 0.57 +/- 0.01 vs. 0.58 +/- 0.01 in aCL negative patients (p=NS); carotid plaque 0.47 +/- 0.13 vs. 0.32 +/- 0.10 (p=NS); and coronary calcium 65.4 +/- 37.4 vs. 65.4 +/- 30.2 (p=NS). In LA positive patients, carotid IMT was 0.59 +/- 0.03 vs. 0.59 +/- 0.02 in LA negative patients (p=NS); carotid plaque 0.07 +/- 0.02 (SE) vs. 0.80 +/- 0.02 (SE) (p=0.06); and coronary calcium 28.1 +/- 3.7 (SE) vs. 85.7 +/- 2.6 (SE) (p=NS). Conclusion: Antiphospholipid antibodies are not associated with subclinical atherosclerosis (carotid IMR, carotid plaque, helical CT coronary calcium), but are associated with actual thrombotic sequelae (myocardial infarction). (c) 2004 Elsevier Ltd. All rights reserved.