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Anticardiolipin antibody and stroke: possible relation of valvular heart disease and embolic events
D Barbut1, J S Borer, D Wallerson
1Department of Neurology, New York Hospital-Cornell Medical Center, N.Y.
Insights
Strokes in anticardiolipin antibody (Acla) syndrome are often embolic from the heart. Valvular heart disease, common in Acla patients, is linked to these cardioembolic strokes.
Area of Science:
- Cardiology
- Neurology
- Rheumatology
Background:
- Anticardiolipin antibody (Acla) syndrome is associated with an increased risk of thrombotic events, including stroke.
- The specific etiology and cardiac involvement in Acla-related strokes require further elucidation.
Purpose of the Study:
- To determine the cause of strokes in patients with Acla syndrome.
- To investigate the relationship between valvular heart disease and stroke in the context of Acla.
Main Methods:
- Retrospective analysis of clinical and objective data from 21 patients with Acla and focal cerebral ischemic events.
- Echocardiographic assessment for valvular abnormalities.
Main Results:
- Left-sided valvular abnormalities were found in 86% of stroke patients versus 42% of non-stroke patients.
- Cardioembolic stroke features were present in 86% of patients experiencing stroke.
Conclusions:
- Strokes in Acla syndrome are predominantly cardioembolic.
- Valvular heart disease is a significant risk factor for stroke in Acla syndrome, suggesting a cardiac source for emboli.
Abstract:
To establish the etiology of strokes related to the anticardiolipin antibody (Acla) syndrome and to determine the relationship of valvular heart disease and stroke in the presence of the Acla, clinical and objective characteristics of 21 patients with Acla, focal cerebral ischemic events were retrospectively analyzed. Twelve (86%) of 14 patients with stroke and 3 (42%) of 7 patients with non-stroke cerebral ischemic events had echocardiographic evidence of left-sided valvular abnormalities. Features characteristic of cardioembolic stroke were present in 12 (86%) of the 14 patients with stroke. The strength of the association between valvular disease and stroke, combined with the clinical and radiologic features noted, suggest that strokes related to the Acla syndrome typically are embolic, from a cardiac source.