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 A. 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

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

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    Kenet, G., Aronis, S., Berkun, Y., Bonduel, M., Chan, A., Goldenberg, N. A., 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, 37(7), 802-809. https://doi.org/10.1055/s-0031-1297171