Lupus & antiphospholipid syndrome
A one-point increase in the Damage Index for Antiphospholipid Syndrome (DIAPS) predicts mortality in thrombotic antiphospholipid syndrome
Main finding · MortalityResult — go to the resultHazard ratio 5.40 95% CI 2.33–12.52Authors' conclusion
Evolving damage in the first five years of illness, but not early damage, predicted mortality regardless of the nature of the first thrombotic event, sex, APS category and age.
Study context
- Population
- Thrombotic APS patients (2006 Sydney criteria), single centre; 71.1% female, 65.9% primary APS, 72.4% Caucasianfollowed up to 43 years (median 10)
- Participants
- 197 patients
- Exposure
- Early damage and early damage increase (delta-DIAPS) vs none, as predictors of mortality
- Delta-DIAPSn = 53/181
- Early damagen = 69
- Outcome
- Mortality
Methodological detailssingle-centre, Kaplan-Meier survival analysis, Cox regression
- Single-centre
- Kaplan-Meier survival analysis
- Cox regression
Main finding
As reported in the abstract
Hazard ratio
5.40
95% CI 2.33–12.52
P < 0.001
Delta-DIAPS
HR 5.40 (95% CI 2.33–12.52); P < 0.001
- Deaths
- 23 (12%)
Observational data: associations, not effects.
Further findings
Risk factors for death
| HR (95% CI) | P value | ||
|---|---|---|---|
| Secondary APS | 3.07 (1.32–7.12) | P = 0.009 | |
| Male sex | 3.14 (1.35–7.33) | P = 0.008 | |
| Age at APS onset ≥40 years | 5.34 (1.96–14.53) | P = 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | P value |
|---|---|
| First arterial event: association with early damage, delta-DIAPS and deathFirst arterial event | P < 0.001 |
| First arterial event: association with early damage, delta-DIAPS and deathFirst arterial event · not associated | P = 0.539 |
| First arterial event: association with early damage, delta-DIAPS and deathFirst arterial event · not associated | P = 0.151 |
Damage development
- Damage developed
- 143 (73.6%)
Original publication
A one-point increase in the Damage Index for Antiphospholipid Syndrome (DIAPS) predicts mortality in thrombotic antiphospholipid syndrome. Clin Exp Rheumatol. Published 28 February 2022. doi:10.
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