To the Editor: The cohort study by Dr Mahmoodi and colleagues1 concluded that microalbuminuria is an independent risk factor for venous thromboembolism (VTE). Although the authors described several limitations to their work, they did not consider an important issue. Multivariable analysis controlled for the most common VTE risk factors that may confound the association between microalbuminuria and VTE. However, a diagnosis of antiphospholipid syndrome (APS) or high titers of antiphospholipid antibodies (aPLs) in the study population was not evaluated. We believe this is crucial.
Musallam KM, Uthman I, Taher AT. Antiphospholipid Syndrome, Microalbuminuria, and Risk of Venous Thromboembolism. JAMA. 2009;302(9):945-946. doi:10.1001/jama.2009.1240