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The frequency of phospholipid antibodies in an unselected stroke population
L M Metz1, S Edworthy, R Mydlarski
1Department of Clinical Neurosciences, Foothills Hospital, University of Calgary, Alberta, Canada.
Insights
Antiphospholipid antibodies (APLA) were not found to be an independent risk factor for ischemic stroke in a general patient population. Further research into lupus anticoagulant
Area of Science:
- Neurology
- Immunology
- Vascular Medicine
Background:
- Antibodies to cardiolipin and other phospholipids are linked to recurrent thrombotic events, including stroke.
- The role of antiphospholipid antibodies (APLA) in ischemic stroke (IS) requires further investigation, particularly in unselected patient cohorts.
Purpose of the Study:
- To assess the prevalence of APLA in ischemic stroke patients.
- To determine if APLA are an independent risk factor for ischemic stroke in patients without known autoimmune diseases.
Main Methods:
- A cohort of 151 ischemic stroke patients and 111 controls were tested for APLA using anticardiolipin antibodies (ACA) ELISA, activated partial thromboplastin time (APTT), and VDRL.
- Patients with systemic lupus erythematosus, systemic sclerosis, or Sjögren's Syndrome were excluded from the study.
Main Results:
- The prevalence of APLA was 12% in ischemic stroke cases and 10% in controls.
- After adjusting for traditional risk factors, the odds ratio for stroke risk associated with APLA was 0.8 (95% CI: 0.4-1.2).
Conclusions:
- APLA do not appear to be an independent risk factor for ischemic stroke in unselected individuals without known systemic lupus erythematosus or systemic sclerosis.
- Further evaluation is warranted to clarify the specific role of lupus anticoagulant in ischemic stroke etiology.
Background:
Antibodies to cardiolipin and other phospholipids have been associated with recurrent thrombotic events, including stroke.
Methods:
Over a 16 month period we assessed an unselected cohort of 151 ischemic stroke patients for the presence of antiphospholipid antibodies. Patients with known systemic lupus erythematosis, systemic sclerosis, or Sjögrens Syndrome were excluded. Sera from patients admitted to hospital with a diagnosis of ischemic stroke (n = 151) and from controls (n = 111) assessed during the same period were tested for antiphospholipid antibodies (APLA) using 3 assays; anticardiolipin antibodies (ACA) by ELISA, prolonged activated partial thromboplastin time (APTT), and VDRL.
Results:
The average age of ischemic stroke cases was 68 years (range 29 to 91) and of controls 63 years (range 29 to 86). The prevalence of APLA detected by at least one of the three methods was 12% for IS cases and 10% for controls. After correcting for known risk factors such as age, gender, diabetes mellitus, heart disease, hypertension, and smoking, the odds ratio for risk of stroke fell to 0.8 (C.I. 0.4 to 1.2).
Conclusions:
Our findings suggest that APLA may not be an independent risk factor for ischemic stroke in unselected persons who do not have known systemic lupus erythematosis or systemic sclerosis but further evaluation of the role of lupus anticoagulant is indicated.