The antiphospholipid syndrome (APS) is characterized by venous or arterial thrombosis
and/or pregnancy morbidity in patients with persistent presence of antiphospholipid
antibodies (aPL). Patients who are diagnosed with APS are identified to have a high
risk of recurrent thrombosis, which can occur despite anticoagulant therapy. The optimal
type, intensity, and duration of anticoagulant therapy for the treatment of APS remain
controversial issues, particularly for arterial thrombosis and recurrent thrombosis.
Patients with persistently positive testing for lupus anticoagulant and elevated levels
of anticardiolipin antibodies and anti-β2 glycoprotein I antibodies—known as triple positivity—appear to be at increased risk
for thrombosis compared with patients who test positive for a single aPL. Recognizing
that patients with APS may potentially have different thrombotic risk profiles may
assist clinicians in assessing the risks, benefits, and optimal duration of anticoagulation.
Future studies that delineate thrombotic risk in APS and evaluate current and novel
anticoagulants as well as nonanticoagulant therapies are required.
Keywords
antiphospholipid antibodies - lupus anticoagulant - anticardiolipin antibodies - anti-β
2-glycoprotein I antibodies - antiphospholipid syndrome