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 A.
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
N1 - Copyright © 2011, Rights Managed by Georg Thieme Verlag KG Stuttgart • New York
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.
UR - http://www.scopus.com/inward/record.url?scp=84055176572&partnerID=8YFLogxK
U2 - 10.1055/s-0031-1297171
DO - 10.1055/s-0031-1297171
M3 - Article
C2 - 22187403
AN - SCOPUS:84055176572
SN - 0094-6176
VL - 37
SP - 802
EP - 809
JO - Seminars in Thrombosis and Hemostasis
JF - Seminars in Thrombosis and Hemostasis
IS - 7
ER -