The adjusted Global AntiphosPholipid Syndrome Score (aGAPSS) for risk stratification in young APS patients with acute myocardial infarction

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:240

Article

Radin, M.^1,2,3  Schreiber, K.^4,5  Costanzo, P.⁶  Cecchi, I.^1,2,3  Roccatello, D.^1,2,3  Baldovino, S.^1,2,3  Bazzan, M.⁷  Cuadrado, M. J.⁸  Sciascia, S.^1,2,3 

[1] S Giovanni Bosco Hosp, Dept Clin & Biol Sci, Ctr Res Immunopathol & Rare Dis, Coordinating Ctr Piemonte & Valle dAosta Network, Turin, Italy

[2] S Giovanni Bosco Hosp, SCDU Nephrol & Dialysis, Piazza Donatore Sangue 3, I-10154 Turin, Italy

[3] Univ Turin, Piazza Donatore Sangue 3, I-10154 Turin, Italy

[4] Guys & St Thomas Hosp, Dept Thrombosis & Haemophilia, London, England

[5] Copenhagen Univ Hosp, Dept Rheumatol, Copenhagen, Denmark

[6] S Giovanni Bosco Hosp, Dept Cardiol, Turin, Italy

[7] S Giovanni Bosco Hosp, UOSD Hematol & Thrombosis Unit, Turin, Italy

[8] Guys & St Thomas NHS Fdn Trust, Louise Coote Lupus Unit, London, England

关键词: Antiphosphospholipid syndrome;    APS;    Acute myocardial infarction;    GAPSS;    aGAPSS;    Risk score;    Thrombosis;   

DOI  :  10.1016/j.ijcard.2017.02.155

来源: Elsevier

【 摘 要 】

Background: Young adults with acute myocardial infarction are a critical group to examine for the purpose of risk factor stratification and modification. In this study we aimed to assess the clinical utility of the adjusted Global AntiphosPholipid Syndrome Score (aGAPSS) for the risk stratification of acute myocardial infarction in a cohort of young patients with antiphospholipid syndrome (APS). Methods: The analysis included 83 consecutive APS patients (<= 50 years old) who presented with arterial or venous thromboembolic events. Data on cardiovascular risk factors and antiphospholipid antibodies (aPL) positivity were retrospectively collected. The aGAPSS was calculated by adding the points corresponding to the risk factors, based on a linear transformation derived from the beta-regression coefficient as follows: 3 for hyperlipidaemia, 1 for arterial hypertension, 5 for aCL IgG/IgM, 4 for anti-b2 glycoprotein I IgG/IgM and 4 for LA. Results: Higher aGAPSS values were observed in patients with acute myocardial infarction when compared to the others [mean aGAPSS 11.9 (S.D. 4.15, range 4-18) Vs. mean aGAPSS 9.2 (S.D. 5.1, range 1-17); T test: p < 0.05]. Significantly higher aGAPSS values were also seen in patients with acute coronary syndrome compared to patients with a history of peripheral or cerebrovascular arterial thrombotic events [mean aGAPSS 11.9 (S.D. 4.15, range 4-18) Vs. mean aGAPSS 6.7 (S.D. 5.7, range 1-17); T test: P < 0.005]. Conclusions: The aGAPSS is based upon a quantitative score and could aid risk stratifying APS patients younger than 50 years for the likelihood of developing coronary thrombotic events and may guide pharmacological treatment for high-risk patients. (C) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

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