Lupus & antiphospholipid syndrome
Risk factors for bleeding in patients with thrombotic antiphospholipid syndrome during antithrombotic therapy
Authors' conclusion
Patients with secondary APS, those experiencing recurrent thrombosis and exposed to combined antithrombotic treatment, are particularly at risk for bleeding.
Study context
- Population
- Patients with thrombotic APS (Sydney criteria) on antithrombotic therapy (female 71.1%; primary APS 65.9%; median disease duration 10 years)
- Participants
- 197 patients
- Outcome
- Prevalence of and risk factors for bleeding (ISTH major bleeding and any bleeding)
Methodological detailssingle-centre, logistic regression, multivariate analysis
- Single-centre
- Logistic regression
- Multivariate analysis
Main finding
As reported in the abstract
Patients experiencing bleeding (167 bleedings)
Eighty patients (40.6%)
Major bleedings, share of all bleedings
22.8%
Thrombocytopenia (<150 × 109 platelets/L) and any bleeding, multivariate
OR = 5.58, 95% CI, 1.93-16.13
Thrombocytopenia and major bleeding, multivariate
OR = 2.82, 95% CI, 1.06-7.51
Observational data: associations, not effects.
Further findings
Thrombocytopenia (<150 × 109 platelets/L) as risk factor for any bleeding
| OR (95% CI) | ||
|---|---|---|
| ThrombocytopeniaAfter multivariate analysis | 5.58 (1.93–16.13) | |
| 0.050.21520Odds ratio (log scale) |
Thrombocytopenia as risk factor for major bleeding
| OR (95% CI) | ||
|---|---|---|
| ThrombocytopeniaAfter multivariate analysis | 2.82 (1.06–7.51) | |
| 0.10.31310Odds ratio (log scale) |
Other risk factors
- Secondary APS associated with major bleeding
- Recurrent thrombosis and high-intensity anticoagulation associated with any bleeding
- Combined antithrombotic therapy increased risk for any and major bleeding
Original publication
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