AB0342 OBSTETRIC AND THROMBOTIC ANTIPHOSPHOLIPID SYNDROME: ARE THEY DIFFERENT ENTITIES?
Authors: R. Serrano Morales, R. Nieto, S. Porta, K. Roberts, L. Lema, C. Maldini, Y. Tissera, J. A. Albiero, V. Savio, C. Goizueta, V. Lobo, A. Broll, N. Cucchiaro, S. ¨perez, P. Izaguirre, A. Estevez, A. I. Abalo, M. Etcheverry, V. I. Bellomio, M. L. Leguizamón, N. Antoniol, C. Perandones, C. Pisoni, M. L. De la Torre, M. García, M. S. Velloso, M. Sacnun, C. Gobbi, D. Guaglione, F. Vivero, V. Saurit, N. Benzaquen, V. Nemman, G. Remondino, M. Machado Escobar, M. Scolnik, C. Danielsen, G. Gomez, A. M. Babini, A. Brigante, A. Luissi, V. V. Castro Coello, L. Sorrentino, H. Berman, P. Alba, G. Pons-Estel
Journal: Annals of the Rheumatic Diseases (2021)

Background: Several studies showed two main clinical phenotypes of antiphospholipid syndrome (APS): thrombotic (TAPS) and obstetric APS (OAPS). Although they have the same autoantibody profile, one of them developed thrombosis and other one obstetric morbidity. Objectives: To study clinical, demographic and antibody profile in patients with TAPS and OAPS. Methods: we retrospectively evaluated TAPS and OAPS patients who were included in Argentine Antiphospholipid antibodies registry. We studied clinical, demographic and antibody profile in both groups. Results: 238 patients were included in the registry. 201 (84.81%) of them were female. 122 (60.69 %) of them fullfilled APS Sydney classification criteria, 47 (38.52%) TAPS and 52 (42.62%) OAPS. 23 (18.85%) patients had both thrombotic and obstetric events so they were excluded in this analysis. Arterial Hypertension (HBP) and Hyperlipidemia were more frequent in TAPS versus OAPS. Older age was found in TAPS as well as in association with Systemic lupus erythematosus (SLE). There was no difference in antibody profile between the 2 groups, and the Global Antiphospholipid Syndrome Score (aGAPSS) was higher in TAPS than OAPS. 18 (38.3%) of TAPS patients had at least 1 pregnancy. Mean number of pregnancies of TAPS was 2.5 (1.10) and 3.84 (1.86) in OAPS. Thrombotic events were not found in TAPS during pregnancy and puerperium. HBP and gestational diabetes (GD) and other pregnancy related comorbidities were found in TAPS. OAPS (n=52) TAPS (n=47) P OAPS (n=52) TAPS(n=18) SLE, n (% ) 11 (21.2) 28 (59.6) 0.0002 N % (DE) N % (DE) aGAPSS, mean (RIQ ) 4 (5) 8 (5) &lt;0.0001 Abortions (&lt;10 weeks) 33 38.4 (36.2) 8 26.5 (35.3) Age, mean (DE ) 39.3 (6.24) 43.1 (13.5) &lt;0.0001 Live Birth 36 33.5 (28.1) 16 72.2 (34.7) HBP, n (% ) 5 (9.6) 15 (31.9) 0.0121 &gt;37 weeks 21 16.4 (2.38) 16 61.1 (31.7) Hyperlipidemia, n (% ) 4 (7.7) 12(25.5) 0.0267 Prematurity &lt;37 &gt;34 weeks 11 8.76 (1.97) 0 - GD, n (% ) 3(5.8) 2(4.3) 0.9999 Prematurity &lt;34 weeks 9 6.37 (1.49) 1 1.39 (5.89) Obesity, n (% ) 8 (15.4) 4 (8.5) 0.2912 Pre eclampsia &gt;34-&lt;37 weeks 1 0.490 (0.0350) 2 4.6 3 ( 0.138) Smoking, n (% ) 11 (21.1) 13 (27.6) 0.4019 Placental Hematoma 3 1.86 (8.18) 1 2.78 (11.8) Sedentary lifestyle, n (% ) 16 (30.8) 17 (36.2) 0.8486 Abruptio Placentae 2 1.96 (9.80) 2 4.17 (12.9) Triple Positivity 5 9.6 4 8.5 0.8323 Normal delivery 20 17.8 (27.9) 14 47.7 (33.9) Double Positivity 1 1.9 3 6.4 Cesarean section 22 17.2 (21.6) 2 11.1 (32.3) Simple Positivity 29 38.5 19 40.4 Urgent Cesarean section 13 9.80 (20.3) 4 12.5 (24.6) GD 2 1.37 (7.49) 1 2.78 (11.8) HBP 6 3.46 (10.3) 3 10.2 (26.3) Conclusion: Antibody profile was similar in TAPS and OAPS. However, clinical manifestations and cardiovascular risk were different. These results should be evaluated in prospective studies. Disclosure of Interests: None declared