Los valores persistentemente positivos de anticuerpos antifosfolipídicos están relacionados con la aparición de trombosis durante el seguimiento de pacientes con síndrome antifosfolipídico

objective: to determine if the presence of persistently positive valúes of antiphospholipid (apl) antibodies is related with recurrent thrombosis in the follow-up of patíent with antiphospholipid syndrome (aps). patients and methods: 141 patients with aps (sapporo's criteria) were analyzed. lupus antico-agulant (lac) valúes and anticardiolipin antibodies (acl) were defined as persistently positive when more than 75% of determinations were positive during the follow-up (apl were measured on 5 or more occasions). thrombosis in the follow-up was defined as a recurrent thrombosis in patient with previous thrombotic events or new events in those patients with previous fetal losses. results: 89 patients suffered from primary aps, 34 associated to systemic lupus erythematosus (sle), 14 to sle-like, 3 to sjogren's syndrome, and 1 to behcet's disease. 56% liad a history of thrombosis, 29% of fetal losses, and 15% both thrombosis and fetal losses. median time of follow-up and between the diagnosis and the last apl determination was 68 months and 65 months (9-180), respectively. median of determinations by patient was 8 (5-27). 31 patients suffered from thrombosis in the follow-up, 28 of them in form of recurrent thrombosis. 58 (41%) patients liad persistently positive apl during follow-up, thus: 23 (39,65%) acl igg y lac, 12 (20,7%) lac, 8 (13,8%) acl igg, 5 (8,6%) acl igm, acl igg y lac, 4 (6,9%) acl igm, 3 (5,1%) acl igg y acl igm y 3 (5,1%) acl igm y lac, respectively. risk for recurrent thrombosis during follow-up was increased in persistently positive apl patients (or 3,53; 95% ci 1,53-8,16; p=0,003) compared with transiently positive apl patients. this higher risk was attributable to persistently positive la (or 3,87; 95% ci 1,68-8,91; p=0,002) and persistently positive acl igg (or 2,91; 95% ci 1,25-6,75; p=0,02). the profile of persistently positive apl related with the appearance of thrombosis during follow-up was the combination of igg acl & la (or 3,51; 95% ci 1,36-