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Nevertheless, the impact of these non-criteria features is still unclear. On a different note, the relevance of one single aPL positive determination in patients with APS manifestations is another domain with limited evidence. We aim to compare the course of SN-APS and single-positive aPL (SP-aPL) patients with that of individuals with APS manifestations without non-criteria features\/aPL positivity (controls).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis of patients with thrombosis\/obstetric morbidity assessed in two European hospitals between 2005 and 2020. Patients were divided into SN-APS, SP-aPL, and control groups. Clinical characteristics, comorbidities, and therapies were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 82 patients were included in the SN-APS group, 88 in the SP-aPL group, and 185 in the control group. In Cox regression model, SN-APS displayed more thrombosis recurrence than controls (HR 3.8, 95% CI 2.2\u20136.5,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) even when adjusting for the presence of hereditary thrombophilia, systemic lupus erythematosus, or contraceptive hormonal treatment. In SP-aPL, the difference in thrombosis recurrence did not reach statistical significance (<jats:italic>p<\/jats:italic>\u2009=\u20090.078). Indefinite anticoagulation (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and<jats:italic>p<\/jats:italic>\u2009=\u20090.008, respectively) and vitamin K antagonist (VKA) use (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 in both cases) were more common in SN-APS\/SP-aPL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SN-APS displayed more thrombosis recurrence, indefinite anticoagulation, and VKA use than controls without non-criteria manifestations. The presence of such features in patients with thrombosis and negative aPL may negatively impact their clinical course.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13075-021-02702-9","type":"journal-article","created":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T07:03:20Z","timestamp":1641193400000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The presence of non-criteria manifestations negatively affects the prognosis of seronegative antiphospholipid syndrome patients: a multicenter study"],"prefix":"10.1186","volume":"24","author":[{"given":"Gilberto Pires","family":"da Rosa","sequence":"first","affiliation":[]},{"given":"Bernardo","family":"Sousa-Pinto","sequence":"additional","affiliation":[]},{"given":"Ester","family":"Ferreira","sequence":"additional","affiliation":[]},{"given":"Olga","family":"Ara\u00fajo","sequence":"additional","affiliation":[]},{"given":"Giuseppe","family":"Barilaro","sequence":"additional","affiliation":[]},{"given":"Paulo","family":"Bettencourt","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6085-492X","authenticated-orcid":false,"given":"Ricard","family":"Cervera","sequence":"additional","affiliation":[]},{"given":"Gerard","family":"Espinosa","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,1,3]]},"reference":[{"issue":"2","key":"2702_CR1","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1111\/j.1538-7836.2006.01753.x","volume":"4","author":"S Miyakis","year":"2006","unstructured":"Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. 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