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| Autor(es): Mostrar menos - |
Santos, Gabrielle M.
;
David, Paula
;
Hen, Or
;
Ontiveros-Austria, Juan Luis
;
Liran, Rotem
;
Rodriguez-Rodriguez, Sergio
;
de Godoi, Julia Cerchiari
;
Patt, Yonatan Shneor
;
Beladev, Shaked
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Okazaki, Erica
;
Collela, Marina
;
Stefanello, Bianca
;
Yamaguti-Hayakawa, Gabriela G.
;
Rothschild, Cynthia
;
Annichino-Bizzachi, Joyce
;
Vargas-Ruiz, Angel
;
Prestes, Paula
;
Rocha, Vanderson
;
de Paula, Erich V.
;
Gendelman, Omer
;
Salomon, Ophira
;
Demichelis-Gomez, Roberta
;
Barrera-Vargas, Ana
;
Amital, Howard
;
Villaca, Paula
;
Shoenfeld, Yehuda
;
Orsi, Fernanda A.
Número total de Autores: 27
|
| Tipo de documento: | Artigo Científico |
| Fonte: | Journal of Thrombosis and Haemostasis; v. 23, n. 10, p. 12-pg., 2025-10-01. |
| Resumo | |
Background Thrombotic risk in primary antiphospholipid syndrome (APS) is a result of complex, yet undefined, interactions among multiple factors. While long-term anticoagulation reduces thrombotic complications, its efficacy varies, with thrombosis recurrence rates ranging from 5% to 20% within 2 years. Emerging therapies may benefit specific APS subgroups, although identifying and stratifying these groups remains a significant challenge. Objectives To identify specific phenotypic subgroups of thrombotic primary APS based on clinical and laboratory characteristics to provide insight for both personalized diagnostic and therapeutic strategies. Methods Multicenter retrospective cohort study including 663 patients with thrombotic primary APS who were followed in Brazil, Israel, and Mexico (2018-2023). Hierarchical cluster analysis categorized patients based on demographics, thrombotic characteristics, comorbidities, and laboratory data. Results Cluster analysis identified 3 distinct phenotypes. Cluster 1 (n = 348) included older patients (median age 43 years) with high cardiovascular risk factors (hypertension, diabetes, and dyslipidemia) and predominantly arterial thrombosis (53%, P < .001). Cluster 2 (n = 119) included younger patients (median age 35 years) with high recurrence rates (71%, P < .001) of venous thromboembolism (80%, P < .001) and higher anticardiolipin prevalence (29%, P < .001). Cluster 3 (n = 196) featured the youngest patients (median age 29 years), predominantly triple antiphospholipid antibody positive (98.5%, P < .001), with complement consumption (C3: 17%, P = .003), thrombocytopenia (12%, P = .05), and venous thrombosis (73%, P < .001). Conclusion This study identified 3 distinct phenotypes of thrombotic primary APS, each characterized by the predominance of cardiovascular risk factors, hypercoagulability, or immunologic derangements. The findings provide a basis for developing personalized management strategies to improve patient outcomes. (AU) | |
| Processo FAPESP: | 23/04157-3 - Avaliação do risco trombótico associado à esplenectomia em pacientes com trombocitopenia imune |
| Beneficiário: | Júlia Bertuzzo Tavares |
| Modalidade de apoio: | Bolsas no Brasil - Iniciação Científica |
| Processo FAPESP: | 22/13216-0 - Interação entre hemostasia e imunidade inata (Imunotrombose): caracterização e exploração fisiopatológica, diagnóstica e terapêutica em doenças infecciosas e inflamatórias |
| Beneficiário: | Erich Vinicius de Paula |
| Modalidade de apoio: | Auxílio à Pesquisa - Temático |