Exploratory Risk Assessment of Cardiovascular Diseases Using Antiphospholipid Antibody-Related Scores in Patients with ANCA-Associated Vasculitis
- 1Division of Rheumatology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
- 2Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- 3Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
Abstract
Background: Antiphospholipid antibodies have been found in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). This study aimed to evaluate the accuracy of the global antiphospholipid syndrome score (GAPSS) derivatives in predicting cardiovascular diseases in Korean patients with AAV, and to derive a simple candidate index for cardiovascular diseases. Methods: This was a retrospective cohort study including 170 patients with AAV. The adjusted GAPSS (aGAPSS), aGAPSS specific for cardiovascular diseases (aGAPSScvd), and aGAPSS for Korean patients with APS (aGAPSS [KAPS]) were calculated in each patient. The cardiovascular diseases were defined as cerebrovascular accident (CVA) or acute coronary syndrome (ACS). The accuracy of each index was assessed by estimating the area under the curve (AUC). An exploratory multivariable Cox proportional hazards model with a backward elimination method was performed to derive a candidate index. Covariates consisting the aGAPSScvd were included in the model. Results: The AUCs of the aGAPSS, aGAPSScvd, and aGAPSS (KAPS) for CVA were 0.507 (p = 0.926), 0.531 (p = 0.676), and 0.493 (p = 0.923), respectively. The AUCs of the aGAPSS, aGAPSScvd, and aGAPSS (KAPS) for ACS were 0.613 (p = 0.441), 0.752 (p = 0.086), and 0.796 (p = 0.043), respectively. The exploratory multivariable model revealed a candidate index, aGAPSScvd for ACS in Korean patients with AAV (aGAPSScvd [KAAV]) = 2 × lupus anticoagulant (LA) + 2 × obesity. The AUC of the aGAPSScvd (KAAV) in predicting ACS was 0.843 (p = 0.019). Conclusions: The two-item candidate index aGAPSScvd (KAAV), consisting of LA and obesity, showed discriminatory ability for ACS, which warrants further validation in larger studies.
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BibTeX
@article{kwon2026exploratory,
title = {{Exploratory Risk Assessment of Cardiovascular Diseases Using Antiphospholipid Antibody-Related Scores in Patients with ANCA-Associated Vasculitis}},
author = {Oh Chan Kwon and Yong-Beom Park and Sang-Won Lee},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207925},
url = {https://www.mdpi.com/2077-0383/15/20/7925},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Exploratory Risk Assessment of Cardiovascular Diseases Using Antiphospholipid Antibody-Related Scores in Patients with ANCA-Associated Vasculitis
AU - Oh Chan Kwon
AU - Yong-Beom Park
AU - Sang-Won Lee
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207925
UR - https://www.mdpi.com/2077-0383/15/20/7925
AB - Background: Antiphospholipid antibodies have been found in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). This study aimed to evaluate the accuracy of the global antiphospholipid syndrome score (GAPSS) derivatives in predicting cardiovascular diseases in Korean patients with AAV, and to derive a simple candidate index for cardiovascular diseases. Methods: This was a retrospective cohort study including 170 patients with AAV. The adjusted GAPSS (aGAPSS), aGAPSS specific for cardiovascular diseases (aGAPSScvd), and aGAPSS for Korean patients with APS (aGAPSS [KAPS]) were calculated in each patient. The cardiovascular diseases were defined as cerebrovascular accident (CVA) or acute coronary syndrome (ACS). The accuracy of each index was assessed by estimating the area under the curve (AUC). An exploratory multivariable Cox proportional hazards model with a backward elimination method was performed to derive a candidate index. Covariates consisting the aGAPSScvd were included in the model. Results: The AUCs of the aGAPSS, aGAPSScvd, and aGAPSS (KAPS) for CVA were 0.507 (p = 0.926), 0.531 (p = 0.676), and 0.493 (p = 0.923), respectively. The AUCs of the aGAPSS, aGAPSScvd, and aGAPSS (KAPS) for ACS were 0.613 (p = 0.441), 0.752 (p = 0.086), and 0.796 (p = 0.043), respectively. The exploratory multivariable model revealed a candidate index, aGAPSScvd for ACS in Korean patients with AAV (aGAPSScvd [KAAV]) = 2 × lupus anticoagulant (LA) + 2 × obesity. The AUC of the aGAPSScvd (KAAV) in predicting ACS was 0.843 (p = 0.019). Conclusions: The two-item candidate index aGAPSScvd (KAAV), consisting of LA and obesity, showed discriminatory ability for ACS, which warrants further validation in larger studies.
SN - 2077-0383
ER -