PT - JOURNAL ARTICLE AU - Eleftheria P. Grika AU - Panayiotis D. Ziakas AU - Elias Zintzaras AU - Haralampos M. Moutsopoulos AU - Panayiotis G. Vlachoyiannopoulos TI - Morbidity, Mortality, and Organ Damage in Patients with Antiphospholipid Syndrome AID - 10.3899/jrheum.110800 DP - 2012 Jan 15 TA - The Journal of Rheumatology PG - jrheum.110800 4099 - http://www.jrheum.org/content/early/2012/01/12/jrheum.110800.short 4100 - http://www.jrheum.org/content/early/2012/01/12/jrheum.110800.full AB - Objective To describe morbidity, organ damage, mortality, and cause of death in patients with antiphospholipid syndrome (APS). Methods Descriptive analysis of 135 patients. Patients were clustered according to initial event: arterial thrombosis including stroke (AT; n = 46), venous thrombosis including pulmonary emboli (VT; n = 53), or pregnancy morbidity (PM; n = 36). Disease progression according to initial event and prevalence of organ damage was observed. Results APS occurs among young individuals (mean age 33.3 ± 11.9 yrs). One-third of the patients have APS secondary to systemic lupus erythematosus (SLE) or SLE-like disease. A broad spectrum of clinical manifestations mark the disease onset even before diagnosis. The pattern of initial presentation is preserved with regard to second event; VT is followed by VT (84%), AT is followed by AT (95%), and PM is followed by PM (88.9%). The highest morbidity is attributed to neurologic damage. PM is more likely to be followed by a second event, yet is associated with less organ damage than AT and VT. After a mean followup of 7.55 years, 29% of patients experienced organ damage and 5 died, with Systemic Lupus International Collaborating Clinics score associated with increased mortality (HR 1.31, 95% CI 1.07–1.60, p = 0.01, per 1-unit increase); hematological malignancies occurred in 2 patients after a cumulative followup of 1020 person-years. Coexistent SLE adds significant damage in patients with APS. Conclusion APS is a disease of young individuals, who experience increased morbidity. Neurologic damage is the most common cause of morbidity. AT at presentation as well as coexistent SLE are associated with poor outcome.