Risk factors in antiphospholipid antibody-associated valvular heart disease: A 383-patient cohort study

Clin Immunol. 2023 Nov:256:109790. doi: 10.1016/j.clim.2023.109790. Epub 2023 Sep 23.

Abstract

Valvular heart disease (VHD) is a prevalent cardiac manifestation in antiphospholipid syndrome (APS) patients. However, risk factors and predictors for antiphospholipid antibody-associated VHD (aPL-VHD) remain vague. We aimed to assess the risk of developing aPL-VHD in aPL-positive patients, by establishing a clinical prediction model upon a cross-sectional cohort from APS-Shanghai database, including 383 APS patients and durable aPL carriers with transthoracic echocardiography investigation. The prevalence of aPL-VHD was 11.5%. Multivariate logistic regression analysis identified three independent risk factors for aPL-VHD: anti-β2GPI IgG (OR 5.970, P < 0.001), arterial thrombosis (OR 2.758, P = 0.007), and stratified estimated glomerular filtration rate levels (OR 0.534, P = 0.001). A prediction model for aPL-VHD, incorporating the three factors, was further developed, which demonstrated good discrimination with a C-index of 0.855 and 0.841 (after bootstrapping), and excellent calibration (P = 0.790). We provide a practical tool for assessing the risk of developing VHD among aPL-positive patients.

Keywords: Antiphospholipid antibodies; Clinical prediction model; Risk factors; Valvular heart disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Antiphospholipid
  • Antiphospholipid Syndrome* / complications
  • China
  • Cohort Studies
  • Cross-Sectional Studies
  • Heart Valve Diseases* / epidemiology
  • Humans
  • Models, Statistical
  • Prognosis
  • Risk Factors

Substances

  • Antibodies, Antiphospholipid