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Anticardiolipin antibodies and mortality in patients with ischemic stroke: a prospective follow-up study

David Tanne1, Luis D'Olhaberriague, Ashish M Trivedi

  • 1Detroit Medical Center Stroke Center, Wayne State University School of Medicine, Detroit, Mich., USA. tanne@post.tau.ac.il

Neuroepidemiology
|March 20, 2002
PubMed

Insights

Anticardiolipin antibodies (aCL) in first ischemic stroke patients indicate higher mortality. However, this increased risk is explained by older age, cardiovascular factors, and detected malignancies during follow-up.

Area of Science:

  • Neurology
  • Immunology
  • Cardiology

Background:

  • Anticardiolipin antibodies (aCL) are associated with thrombotic events.
  • Their role in outcomes for first-time ischemic stroke patients requires further investigation.

Purpose of the Study:

  • To determine if anticardiolipin antibodies (aCL) presence in first ischemic stroke patients is linked to adverse outcomes.
  • To assess the association between aCL levels and mortality, thrombo-occlusive events, and malignancy.

Main Methods:

  • Prospective observational study of 300 first ischemic stroke patients.
  • Evaluation of IgG aCL levels and systematic follow-up for a median of 21 months.
  • Statistical analysis of mortality, combined vascular endpoints, and malignancy rates.

Main Results:

  • Mortality rates were significantly higher in patients with aCL >20 GPL (33%) and >40 GPL (40%) compared to those without.
  • Elevated aCL was associated with a higher incidence of malignancy (19% and 27% respectively).
  • The excess mortality linked to aCL was mitigated after adjusting for age, cardiovascular risk factors, and malignancy.

Conclusions:

  • Elevated aCL levels (>20-40 GPL) in ischemic stroke patients serve as a marker for increased mortality.
  • Older age, cardiovascular risk factors, and malignancy are key contributors to the observed higher mortality in aCL-positive patients.
  • aCL itself may not be the direct cause of increased mortality but rather an indicator of underlying conditions.

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