Was Antiphospholipid Syndrome a Risk Factor of Stroke? A Systemic Review and Meta-Analysis of Cohort Studies

Area of Science:

• Medical Science
• Clinical Research
• Epidemiology

Background:

• Antiphospholipid syndrome (APS) is a condition primarily defined by recurrent thrombotic events.
• The potential link between APS and an increased risk of stroke requires further investigation.

Purpose of the Study:

• To systematically review and meta-analyze existing cohort studies to verify if APS is associated with a higher risk of stroke.
• To quantify the risk of stroke in patients diagnosed with Antiphospholipid syndrome.

Main Methods:

• A comprehensive literature search was conducted across PubMed, Embase, and Cochrane databases.
• Seventeen high-quality cohort studies were included, with quality assessed using the Newcastle-Ottawa Quality Assessment Scale.
• Random-effects modeling was employed for meta-analysis, with heterogeneity assessed using I-squared statistics and publication bias evaluated via funnel plots.

Main Results:

• The pooled hazard ratio for stroke occurrence in APS patients was 1.76 (95% CI: 1.39-2.21), indicating a significantly increased risk.
• Low heterogeneity and stable results from sensitivity analyses support the robustness of the findings.
• Subgroup analysis revealed a pooled risk ratio of 14.70 (95% CI: 7.56-28.56) for stroke in APS patients with co-existing autoimmune diseases, compared to 1.75 (95% CI: 0.99-3.09) for those with only positive antibodies.

Conclusions:

• Antiphospholipid syndrome is identified as a potential risk factor for stroke.
• The risk of stroke is substantially elevated in APS patients, especially when accompanied by other autoimmune conditions.