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Recurrent stroke and thrombo‐occlusive events in the antiphospholipid syndrome
Author(s) -
Levine Steven R.,
Brey Robin L.,
Sawaya Kara L.,
SalowichPalm Leeza,
Kokkinos James,
Kostrzema Beata,
Perry Mary,
Havstad Suzanne,
Carey John
Publication year - 1995
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410380119
Subject(s) - medicine , lupus anticoagulant , stroke (engine) , antiphospholipid syndrome , partial thromboplastin time , cohort , cerebral infarction , prospective cohort study , serology , cardiology , surgery , ischemia , antibody , immunology , thrombosis , coagulation , mechanical engineering , engineering
Abstract We prospectively studied 81 consecutively identified patients with antiphospholipid antibodies (aPLs) who developed focal cerebral ischemia over a 7‐year period. The mean age of this cohort was approximately a decade younger than the average atherothromboembolic stroke victim and women were more commonly involved than men. The frequency of conventional stroke risk factors was lowest in the group of stroke patients with the highest levels of IgG cardiolipin immunoreactivity. Other serological abnormalities associated with aPL (false‐positive Veneral Disease Research Laboratory test, thrombocytopenia, prolonged activated partial thromboplastin time [aPTT]) were more common in the group with over 100 GPL units (high positive). Patients with the highest IgG anticardiolipin titers had the shortest times to subsequent thrombo‐occlusive events. The most common recurrent event was cerebral infarction, often occurring within the first year of follow‐up during a mean prospective follow‐up of 3 years. Over one‐half of the cohort had at least one recurrent thrombo‐occlusive event during follow‐up. This distinct syndrome of cerebral ischemia should be recognized for its younger age at onset, predominance of women, high risk of recurrent thrombo‐occlusive events, and the possible use of the IgG anticardiolipin antibody titer for prognosis.

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