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<p>Patients with thrombotic antiphospholipid syndrome (APS) or subjects with persistent presence of antiphospholipid antibodies (aPLA), defined “carriers”, may develop thrombocytopenia. However, the prevalence and clinical characteristics associated with thrombocytopenia remain poorly understood. We aimed to describe the prevalence and the clinical characteristics associated with thrombocytopenia in APS patients and aPLA carriers included in the Survey on AnTicoAgulated Patients-RegisTry on antiphospholipid antibodies (START-APS), a multicentre prospective registry. Thrombocytopenia was defined as a platelet count &lt; 150 × 10<sup>9</sup>/L, while moderate-to-severe form was defined as &lt; 100 × 10<sup>9</sup>/L. Logistic regression analysis was performed, and results were expressed as Odds Ratio (OR) and 95% confidence interval (95%CI). A total of 464 patients were included (148 aPLA carriers, 316 APS), mean age was 57.3 ± 15.6&#xa0;years, and 66.5% were women. 63 (13.6%) patients presented with thrombocytopenia; 15.2% in APS patients and 10.1% in aPLA carriers (<i>p</i> = 0.138). Overall, triple positive pattern (OR 1.90, <i>p</i> = 0.002), livedo reticularis (OR 3.57, <i>p</i> = 0.029), heart failure (OR 4.52, <i>p</i> = 0.039), and female sex (OR 0.59, <i>p</i> = 0.011) were associated with thrombocytopenia. Triple positivity (OR 5.44, <i>p</i> &lt; 0.001) and history of myocardial infarction (OR 6.52, <i>p</i> = 0.009) were associated with moderate-to-severe thrombocytopenia. Thrombocytopenia may occur early also in aPLA carriers, raising to 15% in APS patients, especially in those presenting with triple positivity and cardiovascular involvement. This association was confirmed also with moderate-to-severe thrombocytopenia.</p>

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Thrombocytopenia in carriers and patients with antiphospholipid syndrome: insights from the nationwide START-APS registry

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月16日

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  • Francesco Del Sole,
  • Tommaso Bucci,
  • Danilo Menichelli,
  • Emilia Antonucci,
  • Daniela Poli,
  • Vittorio Pengo,
  • Paul R. J. Ames,
  • Doris Barcellona,
  • Piera Sivera,
  • Attilia Maria Pizzini,
  • Giuseppe Vercillo,
  • Daniele Pastori,
  • Pasquale Pignatelli,
  • Raffaella Benedetti,
  • Davide Imberti,
  • Silvia Bozzato,
  • Giovanna Colombo,
  • Laura Banov,
  • Elisa Bison,
  • Verusca Brusegan,
  • Luca Barcella,
  • Francesca Schieppati,
  • Anna Falanga,
  • Chiara Ambaglio,
  • Sara Gamba,
  • Marina Marchetti,
  • Eugenio Bucherini,
  • Antonio Chistolini,
  • Maria Sophia Cotelli,
  • Erica De Candia,
  • Alice Lipari,
  • Vittorio Fregoni,
  • Paolo Gresele,
  • Ariela Hoxha,
  • Corrado Lodigiani,
  • Alberto Maino,
  • Gessica Marchesini,
  • Giuseppe Carli,
  • Alberto Tosetto,
  • Vincenzo Oriana,
  • Pancani Roberta,
  • Simona Pedrini,
  • Gian Marco Podda,
  • Bianca Clerici,
  • Elena Lotti,
  • Domenico Prisco,
  • Maria Canfora,
  • Elena Silvestri,
  • Luca Puccetti,
  • Jacopo Agnelli Giacchello,
  • Laura Contino,
  • Roberto Santi,
  • Luca Sarti,
  • Anna Aiello,
  • Carmine Spataro,
  • Sophie Testa,
  • Rossella Morandini,
  • Oriana Paoletti,
  • Andrea Toma,
  • Antonella Tufano,
  • Vercillo Giuseppe,
  • Nello Zanatta,
  • Beniamino Zalunardo,
  • Adriana Visonà,
  • Michela Frulla

摘要

Patients with thrombotic antiphospholipid syndrome (APS) or subjects with persistent presence of antiphospholipid antibodies (aPLA), defined “carriers”, may develop thrombocytopenia. However, the prevalence and clinical characteristics associated with thrombocytopenia remain poorly understood. We aimed to describe the prevalence and the clinical characteristics associated with thrombocytopenia in APS patients and aPLA carriers included in the Survey on AnTicoAgulated Patients-RegisTry on antiphospholipid antibodies (START-APS), a multicentre prospective registry. Thrombocytopenia was defined as a platelet count < 150 × 109/L, while moderate-to-severe form was defined as < 100 × 109/L. Logistic regression analysis was performed, and results were expressed as Odds Ratio (OR) and 95% confidence interval (95%CI). A total of 464 patients were included (148 aPLA carriers, 316 APS), mean age was 57.3 ± 15.6 years, and 66.5% were women. 63 (13.6%) patients presented with thrombocytopenia; 15.2% in APS patients and 10.1% in aPLA carriers (p = 0.138). Overall, triple positive pattern (OR 1.90, p = 0.002), livedo reticularis (OR 3.57, p = 0.029), heart failure (OR 4.52, p = 0.039), and female sex (OR 0.59, p = 0.011) were associated with thrombocytopenia. Triple positivity (OR 5.44, p < 0.001) and history of myocardial infarction (OR 6.52, p = 0.009) were associated with moderate-to-severe thrombocytopenia. Thrombocytopenia may occur early also in aPLA carriers, raising to 15% in APS patients, especially in those presenting with triple positivity and cardiovascular involvement. This association was confirmed also with moderate-to-severe thrombocytopenia.