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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Antiphosphatidylserine Antibodies and Clinical Outcomes in Patients With Acute Ischemic Stroke
Xiaoqing Bu1, Hao Peng1, Chongke Zhong1
1From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (X.B., H.P., C.Z., Tan Xu, Tian Xu, Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (X.B., H.P., C.-S.C., J.C., J.H.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (Tian Xu); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei (Y.P.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Neurology and Cardiology, Dongping County People's Hospital, Shandong, China (D.Z.); Department of Neurology, the 88th Hospital of PLA, Shandong, China (J.Z.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Background And Purpose:
Antiphosphatidylserine antibodies (aPS) have been associated with the risk of ischemic stroke. However, it remains unclear whether aPS will influence clinical outcomes in patients with acute ischemic stroke.
Methods:
A total of 3013 patients with acute ischemic stroke recruited from 26 hospitals across China from August 2009 to May 2013 were included in the study The primary outcome was a combination of death and major disability (modified Rankin Scale score ≥3) at 3 months after stroke. Secondary outcomes included death, major disability, recurrent stroke, and vascular events.
Results:
Composite outcome of death and major disability rates were 29.1% versus 23.9% in aPS-positive and aPS-negative groups. Compared with aPS-negative, adjusted odds ratios or hazard ratios (95% confidence interval) associated with aPS-positive were 1.35 (1.07-1.71), 1.63 (0.99-2.69), and 1.25 (0.98-1.59) for composite outcome of death or major disability, death, and major disability, respectively. For 1 interquartile range increase of aPS, the adjusted odds ratios or hazard ratios were 1.10 (1.01-1.20), 1.19 (1.05-1.35), and 1.05 (0.96-1.14), respectively. Adding aPS status to a model containing conventional risk factors improved risk prediction for composite outcome of death or major disability (net reclassification improvement index=11.3%, P=0.006; integrated discrimination improvement=0.2%, P=0.04). There was no significant association between aPS and risks of recurrent stroke and vascular events.
Conclusions:
We found that positive aPS increased risks of death or major disability at 3 months after an acute ischemic stroke, suggesting that aPS might be a prognostic marker for ischemic stroke.
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