# Assessing the Impact: The Damage Index for Antiphospholipid Syndrome in the Context of Other Autoimmune Diseases and Cardiovascular Risk Factors

## TL;DR

This study shows that secondary APS causes more organ damage than primary APS, and that conditions like hypertension and diabetes worsen outcomes in APS patients.

## Contribution

The study identifies SAPS and cardiovascular risk factors as significant contributors to increased organ damage in APS patients.

## Key findings

- Secondary APS patients had significantly higher DIAPS scores compared to primary APS patients.
- Hypertension and diabetes were associated with increased organ damage in APS patients.
- Dyslipidemia influenced the relationship between APS autoimmunity and cumulative damage.

## Abstract

Background

Antiphospholipid syndrome (APS) is a chronic autoimmune disorder characterized by thrombotic events and organ damage, often leading to significant morbidity and mortality. The Damage Index for Antiphospholipid Syndrome (DIAPS) was developed to quantify irreversible damage in these patients, providing a tool for better disease management.

Objectives

This study investigates the long-term accumulation of organ damage in patients with thrombotic APS. Specifically, it examines how damage severity differs between primary APS (PAPS) and secondary APS (SAPS) and how traditional cardiovascular risk factors contribute to disease progression. Understanding these interactions may help refine patient management strategies.

Methods

A retrospective analysis of 141 patients diagnosed with thrombotic APS was conducted using medical records. The DIAPS score was calculated for each patient, and its association with autoimmune comorbidities and cardiovascular risk factors was analyzed through statistical modeling.

Results

Among the 141 APS patients (86% female, mean age 52 years), systemic lupus erythematosus was the most frequent associated autoimmune disease (92%). Arterial hypertension was present in 39% of cases, dyslipidemia in 28%, and type 2 diabetes in 10%. Patients with SAPS had significantly higher DIAPS scores than those with PAPS (p=0.044). Hypertension and diabetes were linked to increased organ damage, while dyslipidemia influenced the relationship between APS-related autoimmunity and cumulative damage.

Conclusions

Patients with secondary APS experience more severe long-term damage compared to those with primary APS. Additionally, cardiovascular risk factors, particularly hypertension and diabetes, worsen disease progression. These findings underscore the need for a multidisciplinary approach that integrates autoimmune disease management with cardiovascular risk control to prevent irreversible complications in APS patients.