用于年轻急性心肌梗死抗磷脂综合征（APS）患者风险分层的校正全球抗磷脂综合征评分（aGAPSS）

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

作者信息

Radin M, Schreiber K, Costanzo P, Cecchi I, Roccatello D, Baldovino S, Bazzan M, Cuadrado M J, Sciascia S

机构信息

Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, and SCDU Nephrology and Dialysis, S. Giovanni Bosco Hospital and University of Turin, Turin, Italy.

Department of Thrombosis and Haemophilia, Guy's and St Thomas' Hospital, London, United Kingdom; Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark.

出版信息

Int J Cardiol. 2017 Aug 1;240:72-77. doi: 10.1016/j.ijcard.2017.02.155. Epub 2017 Mar 24.

DOI:10.1016/j.ijcard.2017.02.155

PMID:28385357

Abstract

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 (≤50years 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 ß-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 50years for the likelihood of developing coronary thrombotic events and may guide pharmacological treatment for high-risk patients.

摘要

背景

对于急性心肌梗死的年轻成年人，为了进行风险因素分层和调整，这是一个关键的研究群体。在本研究中，我们旨在评估调整后的全球抗磷脂综合征评分（aGAPSS）在一组患有抗磷脂综合征（APS）的年轻患者中对急性心肌梗死风险分层的临床实用性。

方法

分析纳入了83例连续的（年龄≤50岁）出现动脉或静脉血栓栓塞事件的APS患者。回顾性收集心血管危险因素和抗磷脂抗体（aPL）阳性的数据。aGAPSS通过将对应于危险因素的分数相加来计算，基于从β回归系数得出的线性转换，如下：高脂血症为3分，动脉高血压为1分，抗心磷脂抗体IgG/IgM为5分，抗β2糖蛋白I IgG/IgM为4分，狼疮抗凝物为4分。

结果

与其他患者相比，急性心肌梗死患者的aGAPSS值更高[平均aGAPSS 11.9（标准差4.15，范围4 - 18）对平均aGAPSS 9.2（标准差5.1，范围1 - 17）；t检验：p<0.05]。与有外周或脑血管动脉血栓形成事件病史的患者相比，急性冠状动脉综合征患者的aGAPSS值也显著更高[平均aGAPSS 11.9（标准差4.15，范围4 - 18）对平均aGAPSS 6.7（标准差5.7，范围1 - 17）；t检验：P<0.005]。