The main results of our study were as follows: (1) the prevalence of aPL in this population of SSc patients was 6.4% (1.6, 1.2, 4.4% for LA, aCL, and anti-β2GpI, respectively) and the overall pooled prevalence of aPL in SSc was 14% (9–20) by meta-analysis, (2) there was an association between VT and miscarriage and aPL positivity, (3) higher levels of aCL were associated with a higher risk of PAH and VT, and higher levels of anti-β2GpI with a higher risk of miscarriage. This evidence concerns the gene ACLY and systemic sclerosis.