CO30 | Risk factor for damage accrual in primary antiphospholipid syndrome: a retrospective single-center cohort study

Premises and Purpose of the study: Despite anticoagulant therapy, in primary antiphospholipid syndrome (PAPS), a higher rate of recurrent events occurs, leading to potentially accrued damage with a negative impact on quality of life. We evaluated risk factors and APS subsets associated with accrual damage.Materials and Methods: We conducted a retrospective single-center study. We assessed medical records of 282 PAPS patients, with a median age of 36 years, followed for a median of 195 months. The primary endpoint was the damage accrual during follow-up, defined as organ impairment present for at least six months or caused permanent loss. The secondary endpoints were early organ damage presented within six months and death.Results: Eighty presented accrual damage at follow-up; 52.5% presented organ damage within the first 6 months after diagnosis; 41.3% had more than one organ damage. The neuropsychiatric domain was the most frequently involved (38.8%), followed by peripheral vasculopathy, renal, and cardiac domains. 7 patients died and damage accrual was associated with a 6-fold risk of death. Microangiopathy and non-criteria manifestations were independent risk factors for accrual damage with 5-fold and 4-fold higher risk, respectively. The cumulative incidence of damage accrual was increased by 5.7-fold and 3.6-fold in patients with microangiopathy and those with non-criteria manifestations.Conclusions: Our data showed a high frequency of damage accrual in APS patients. Microangiopathy and non-criteria manifestations were independent risk factors for damage accrual.