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Stroke and antiphospholipid syndrome-antiphospholipid antibodies are a risk factor for an ischemic cerebrovascular

Nataša Gašperšič1, Marjan Zaletel2, Jan Kobal2

  • 1Department of Rheumatology, University Medical Centre Ljubljana, Vodnikova 62, SI-1000, Ljubljana, Slovenia. natasa.gaspersic@kclj.si.

Clinical Rheumatology
|August 9, 2018
PubMed

Insights

Antiphospholipid antibodies are an independent risk factor for cerebrovascular events (CVEs). In most antiphospholipid syndrome (APS) patients, antiplatelet therapy is sufficient for secondary prevention in the first year after a CVE.

Area of Science:

  • Neurology
  • Immunology
  • Cardiology

Background:

  • Cerebrovascular events (CVEs) are a significant health concern.
  • The role of antiphospholipid antibodies in CVE development and management is not fully understood.
  • Antiphospholipid syndrome (APS) is an autoimmune disorder associated with an increased risk of thrombosis.

Purpose of the Study:

  • To determine the frequency of CVE patients meeting laboratory criteria for APS.
  • To investigate if persistent antiphospholipid antibodies are a risk factor for CVE.
  • To evaluate the efficacy of treatment strategies in the first year post-CVE.

Main Methods:

  • Prospective follow-up of 89 acute CVE patients for 1 year.
  • Testing sera for lupus anticoagulants, anticardiolipin, anti-β2-glycoprotein I, anti-phosphatidylserine/prothrombin, and anti-annexin V antibodies.
  • Analyzing the association between antiphospholipid antibodies and CVE risk, and treatment outcomes.

Main Results:

  • 22% of CVE patients met the criteria for APS (definitive or probable).
  • Persistent antiphospholipid antibodies were significantly associated with CVE risk (OR, 4.62).
  • No significant difference in CVE recurrence was observed between APS-CVE and non-APS-CVE patients on acetyl salicylic acid therapy.

Conclusions:

  • Antiphospholipid antibodies are an independent risk factor for CVE.
  • Antiplatelet therapy appears sufficient for secondary CVE thromboprophylaxis in most APS patients within the first year post-event.

Keywords:
Antiphospholipid antibodyRiskStrokeTreatment

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