Ethnicity and Antiphospholipid Syndrome in Israel.

BACKGROUND The Antiphospholipid Syndrome (APS) is an acquired coagulopathy associated with the presence of antiphospholipid antibodies. Whether ethnicity modulates APS clinical course is not known. The aim of our study was to assess the interplay ethnicity and APS in Israel. METHODS We retrospectively evaluated the ethnic distribution of APS patients from 3 medical centres in Israel compared to the general population. Ethnic groups were defined according to the Israeli bureau of statistics as Ashkenazi (European), former Union of Soviet Socialist Republics (USSR), North African, Asian (West Asia, Greece and Turkey), Israeli Arabs and others. RESULTS Our cohort included 382 patients. With the prevalence of Ashkenazi and Asian ethnicities were more pronounce (33% vs. 12.8% and 15.4% vs. 7.7% respectively; p<0.001), while Israeli Arabs were less represented (5.2% vs. 31.1%; p<0.001) relative to their part in the general population. Arab patients were younger at presentation (28±10y vs. 34±13y; p<0.001), more likely to present with venous thrombosis (50% vs. 35%; p=0.037) and to suffer from venous thrombotic recurrence (45% vs.16%; p<0.001) compared to other ethnicities. Mortality was higher among patients of Asian ethnic origin (8.8% vs. 1.1%; p=0.005), intriguingly this group suffered more often from cardiovascular risk factors (i.e. dyslipidaemia as well hypertension). CONCLUSION Ethnicity may affect the prevalence and/or natural course of APS which is less prevalent and differs clinically in Israeli Arabs patients while mortality was linked with Asian ethnicity.