INFLUENCE OF THE ANTIPHOSPHOLIPID SYNDROME IN THE SURVIVAL OF PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS

Objective. To determine prognostic factors for mortality in a cohort o f 667 patients with systemic lupus erythematosus (SLE) including those variables associated with the presence of antiphospholipid antibodies (aPL) as well as antiphospholipid syndrome (APS) itself. Methods. Ana lysis of the cohort under a nested case control design by means of Cox proportional hazards regression with and without stepwise method. Res ults. During the 2039 person-years of followup, there were 49 deaths ( cases). Thrombocytopenia, arterial occlusions, and hemolytic anemia we re the aPL related manifestations that were associated with decreased survival in univariate analyses. The first 2 were also selected among risk factors for mortality in stepwise Cox multivariate analysis. The syndrome itself was also associated with increased mortality rates, in dependently of other variables. Conclusion. APS is among the variables that confer decreased survival on patients with SLE. This decreased s urvival is due to some (e.g., thrombocytopenia or arterial occlusions) , but not all, of the manifestations of APS.