Impact of persistent antiphospholipid antibodies on risk of incident symptomatic thromboembolism in children: A systematic review and meta-analysis

Gili Kenet, Sofia Aronis, Yackov Berkun, Mariana Bonduel, Anthony Chan, Neil Goldenberg, Susanne Holzhauer, Alfonso Iorio, Janna Journeycake, Ralf Junker, Christoph Male, Marilyn Manco-Johnson, Patti Massicotte, Rolf Mesters, Paul Monagle, Heleen Van Ommen, Leslie Rafini, Paolo Simioni, Guy Young, Ulrike Nowak-Göttl

Research output: Contribution to journalArticle

Abstract

The aim of this study was to estimate the impact of antiphospholipid (aPL) antibodies on the risk of incident thromboembolism (TE; arterial and venous) in children via meta-analysis of published observational studies. A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1966 to 2010 was conducted using keywords in combination both as MeSH terms and text words. Two authors independently screened citations and those meeting the a priori defined inclusion criteria were retained. Data on year of publication, study design, country of origin, number of patients/controls, ethnicity, TE type, and frequency of recurrence were abstracted. Heterogeneity across studies was evaluated, and summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using either fixed-effects or random-effects models. Of 504, 16 pediatric studies met the inclusion criteria. In total 1403 patients and 1667 population-based controls 18 years were enrolled. No significant heterogeneity was discerned across studies, and no publication bias was detected. Thus, data from arterial and venous TE were analyzed together. In addition, meta-regression analysis did not reveal statistically significant differences between site of TE, age at first TE, country, or publication year. A statistically significant association with a first TE was demonstrated for persistent aPL antibodies, with an overall summary ORs/CI of 5.9/3.69.7 (arterial 6.6/3.512.4; deep vein thrombosis 4.9/2.210.9). The present meta-analysis indicates that detection of persistent aPL is clinically meaningful in children with, or at risk for, TE and underscores the importance of pediatric thrombophilia screening programs.

Original languageEnglish (US)
Pages (from-to)802-809
Number of pages8
JournalSeminars in Thrombosis and Hemostasis
Volume37
Issue number7
DOIs
StatePublished - 2011
Externally publishedYes

Fingerprint

Antiphospholipid Antibodies
Thromboembolism
Meta-Analysis
Publications
Odds Ratio
Confidence Intervals
Pediatrics
Publication Bias
Thrombophilia
Population Control
Venous Thrombosis
Libraries
Observational Studies
Regression Analysis
Databases
Recurrence

Keywords

  • Antiphospholipid antibodies
  • children
  • meta-analysis
  • recurrence
  • thromboembolism

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

Cite this

Impact of persistent antiphospholipid antibodies on risk of incident symptomatic thromboembolism in children : A systematic review and meta-analysis. / Kenet, Gili; Aronis, Sofia; Berkun, Yackov; Bonduel, Mariana; Chan, Anthony; Goldenberg, Neil; Holzhauer, Susanne; Iorio, Alfonso; Journeycake, Janna; Junker, Ralf; Male, Christoph; Manco-Johnson, Marilyn; Massicotte, Patti; Mesters, Rolf; Monagle, Paul; Van Ommen, Heleen; Rafini, Leslie; Simioni, Paolo; Young, Guy; Nowak-Göttl, Ulrike.

In: Seminars in Thrombosis and Hemostasis, Vol. 37, No. 7, 2011, p. 802-809.

Research output: Contribution to journalArticle

Kenet, G, Aronis, S, Berkun, Y, Bonduel, M, Chan, A, Goldenberg, N, Holzhauer, S, Iorio, A, Journeycake, J, Junker, R, Male, C, Manco-Johnson, M, Massicotte, P, Mesters, R, Monagle, P, Van Ommen, H, Rafini, L, Simioni, P, Young, G & Nowak-Göttl, U 2011, 'Impact of persistent antiphospholipid antibodies on risk of incident symptomatic thromboembolism in children: A systematic review and meta-analysis', Seminars in Thrombosis and Hemostasis, vol. 37, no. 7, pp. 802-809. https://doi.org/10.1055/s-0031-1297171
Kenet, Gili ; Aronis, Sofia ; Berkun, Yackov ; Bonduel, Mariana ; Chan, Anthony ; Goldenberg, Neil ; Holzhauer, Susanne ; Iorio, Alfonso ; Journeycake, Janna ; Junker, Ralf ; Male, Christoph ; Manco-Johnson, Marilyn ; Massicotte, Patti ; Mesters, Rolf ; Monagle, Paul ; Van Ommen, Heleen ; Rafini, Leslie ; Simioni, Paolo ; Young, Guy ; Nowak-Göttl, Ulrike. / Impact of persistent antiphospholipid antibodies on risk of incident symptomatic thromboembolism in children : A systematic review and meta-analysis. In: Seminars in Thrombosis and Hemostasis. 2011 ; Vol. 37, No. 7. pp. 802-809.
@article{53fb6d64da7d470ca6512783eff6991c,
title = "Impact of persistent antiphospholipid antibodies on risk of incident symptomatic thromboembolism in children: A systematic review and meta-analysis",
abstract = "The aim of this study was to estimate the impact of antiphospholipid (aPL) antibodies on the risk of incident thromboembolism (TE; arterial and venous) in children via meta-analysis of published observational studies. A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1966 to 2010 was conducted using keywords in combination both as MeSH terms and text words. Two authors independently screened citations and those meeting the a priori defined inclusion criteria were retained. Data on year of publication, study design, country of origin, number of patients/controls, ethnicity, TE type, and frequency of recurrence were abstracted. Heterogeneity across studies was evaluated, and summary odds ratios (ORs) and 95{\%} confidence intervals (CIs) were calculated using either fixed-effects or random-effects models. Of 504, 16 pediatric studies met the inclusion criteria. In total 1403 patients and 1667 population-based controls 18 years were enrolled. No significant heterogeneity was discerned across studies, and no publication bias was detected. Thus, data from arterial and venous TE were analyzed together. In addition, meta-regression analysis did not reveal statistically significant differences between site of TE, age at first TE, country, or publication year. A statistically significant association with a first TE was demonstrated for persistent aPL antibodies, with an overall summary ORs/CI of 5.9/3.69.7 (arterial 6.6/3.512.4; deep vein thrombosis 4.9/2.210.9). The present meta-analysis indicates that detection of persistent aPL is clinically meaningful in children with, or at risk for, TE and underscores the importance of pediatric thrombophilia screening programs.",
keywords = "Antiphospholipid antibodies, children, meta-analysis, recurrence, thromboembolism",
author = "Gili Kenet and Sofia Aronis and Yackov Berkun and Mariana Bonduel and Anthony Chan and Neil Goldenberg and Susanne Holzhauer and Alfonso Iorio and Janna Journeycake and Ralf Junker and Christoph Male and Marilyn Manco-Johnson and Patti Massicotte and Rolf Mesters and Paul Monagle and {Van Ommen}, Heleen and Leslie Rafini and Paolo Simioni and Guy Young and Ulrike Nowak-G{\"o}ttl",
year = "2011",
doi = "10.1055/s-0031-1297171",
language = "English (US)",
volume = "37",
pages = "802--809",
journal = "Seminars in Thrombosis and Hemostasis",
issn = "0094-6176",
publisher = "Thieme Medical Publishers",
number = "7",

}

TY - JOUR

T1 - Impact of persistent antiphospholipid antibodies on risk of incident symptomatic thromboembolism in children

T2 - A systematic review and meta-analysis

AU - Kenet, Gili

AU - Aronis, Sofia

AU - Berkun, Yackov

AU - Bonduel, Mariana

AU - Chan, Anthony

AU - Goldenberg, Neil

AU - Holzhauer, Susanne

AU - Iorio, Alfonso

AU - Journeycake, Janna

AU - Junker, Ralf

AU - Male, Christoph

AU - Manco-Johnson, Marilyn

AU - Massicotte, Patti

AU - Mesters, Rolf

AU - Monagle, Paul

AU - Van Ommen, Heleen

AU - Rafini, Leslie

AU - Simioni, Paolo

AU - Young, Guy

AU - Nowak-Göttl, Ulrike

PY - 2011

Y1 - 2011

N2 - The aim of this study was to estimate the impact of antiphospholipid (aPL) antibodies on the risk of incident thromboembolism (TE; arterial and venous) in children via meta-analysis of published observational studies. A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1966 to 2010 was conducted using keywords in combination both as MeSH terms and text words. Two authors independently screened citations and those meeting the a priori defined inclusion criteria were retained. Data on year of publication, study design, country of origin, number of patients/controls, ethnicity, TE type, and frequency of recurrence were abstracted. Heterogeneity across studies was evaluated, and summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using either fixed-effects or random-effects models. Of 504, 16 pediatric studies met the inclusion criteria. In total 1403 patients and 1667 population-based controls 18 years were enrolled. No significant heterogeneity was discerned across studies, and no publication bias was detected. Thus, data from arterial and venous TE were analyzed together. In addition, meta-regression analysis did not reveal statistically significant differences between site of TE, age at first TE, country, or publication year. A statistically significant association with a first TE was demonstrated for persistent aPL antibodies, with an overall summary ORs/CI of 5.9/3.69.7 (arterial 6.6/3.512.4; deep vein thrombosis 4.9/2.210.9). The present meta-analysis indicates that detection of persistent aPL is clinically meaningful in children with, or at risk for, TE and underscores the importance of pediatric thrombophilia screening programs.

AB - The aim of this study was to estimate the impact of antiphospholipid (aPL) antibodies on the risk of incident thromboembolism (TE; arterial and venous) in children via meta-analysis of published observational studies. A systematic search of electronic databases (Medline, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1966 to 2010 was conducted using keywords in combination both as MeSH terms and text words. Two authors independently screened citations and those meeting the a priori defined inclusion criteria were retained. Data on year of publication, study design, country of origin, number of patients/controls, ethnicity, TE type, and frequency of recurrence were abstracted. Heterogeneity across studies was evaluated, and summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using either fixed-effects or random-effects models. Of 504, 16 pediatric studies met the inclusion criteria. In total 1403 patients and 1667 population-based controls 18 years were enrolled. No significant heterogeneity was discerned across studies, and no publication bias was detected. Thus, data from arterial and venous TE were analyzed together. In addition, meta-regression analysis did not reveal statistically significant differences between site of TE, age at first TE, country, or publication year. A statistically significant association with a first TE was demonstrated for persistent aPL antibodies, with an overall summary ORs/CI of 5.9/3.69.7 (arterial 6.6/3.512.4; deep vein thrombosis 4.9/2.210.9). The present meta-analysis indicates that detection of persistent aPL is clinically meaningful in children with, or at risk for, TE and underscores the importance of pediatric thrombophilia screening programs.

KW - Antiphospholipid antibodies

KW - children

KW - meta-analysis

KW - recurrence

KW - thromboembolism

UR - http://www.scopus.com/inward/record.url?scp=84055176572&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84055176572&partnerID=8YFLogxK

U2 - 10.1055/s-0031-1297171

DO - 10.1055/s-0031-1297171

M3 - Article

C2 - 22187403

AN - SCOPUS:84055176572

VL - 37

SP - 802

EP - 809

JO - Seminars in Thrombosis and Hemostasis

JF - Seminars in Thrombosis and Hemostasis

SN - 0094-6176

IS - 7

ER -