Clinical StudiesAnticardiolipin Antibodies Predict Early Recurrence of Thromboembolism and Death Among Patients with Venous Thromboembolism Following Anticoagulant Therapy
Section snippets
Patients
Patients were recruited during 3 years for a multicenter trial at 16 hospitals in Sweden of the optimum duration of oral anticoagulation after venous thromboembolism. A total of 1,124 patients of at least 15 years of age were included, 897 with a first episode of deep vein thrombosis or pulmonary embolism [14] and 227 patients with a second episode [15]. Main exclusion criteria were previously diagnosed malignant disease (152), severe current disease (137), insufficient ascertainment of venous
Results
Patients with a first or second episode of venous thromboembolism were recruited during the period April 12, 1988 to April 18, 1991. Most patients had deep-vein thrombosis (Table 1). We were unable to obtain samples for anticardiolipin antibodies for between 5% and 9% of the patients due to death or severe, intercurrent disease before the 6-month follow-up.
Among patients with a first episode of venous thromboembolism, 10 patients received shorter, and 14 received longer, anticoagulation than
Discussion
As opposed to most previous studies addressing the significance of antiphospholipid antibodies, our study is based on a sample of patients presenting with venous thromboembolism. In 15% of the patients tested after 6 months, elevated titers of anticardiolipin antibodies were found, corresponding to the APL-T type 1 syndrome [17]. Only two of these patients turned out to have systemic lupus erythematosus. Our analysis of antiphospholipid antibodies was limited to IgG anticardiolipin antibody,
Acknowledgements
Grants were obtained from Swedish Heart Lung Foundation, the Swedish Society of Medicine, the funds of the Karolinska Institute, Skandia, Trygg-Hansa, Triolab, Nycomed, and Stago.
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The investigators and institutions participating in the Duration of Anticoagulation (DURAC) Study Group are listed in the Appendix A.