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Cited by 111Systemic Lupus Erythematosus ResearchAcute Ischemic Stroke ManagementCerebral Venous Sinus Thrombosis

Cerebrovascular ischemic events with high positive anticardiolipin antibodies

Verro, Piero, Levine, Steven R., Tietjen, Gretchen E.·1998·Stroke
DOI 10.1161/01.str.29.11.2245
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Abstract

Background and purpose The aim of our study was to characterize the patient profile and prognostic value associated with high positive IgG (>100 GPL) anticardiolipin antibodies (aCL). Methods We studied the clinical, laboratory, radiological, and prospective historical features of ischemic cerebrovascular disease in patients with >100 GPL titers. From our neurology department, 27 consecutive patients were prospectively identified and followed up (mean follow-up time, 34 months). Results The mean age of our cohort was 41 years. Lupuslike illness occurred in 3; 23 had primary antiphospholipid syndrome, including 3 who met criteria for Sneddon's syndrome; 1 patient had progressive systemic sclerosis. Cerebral infarcts occurred in 74% and were recurrent in 37%. Systemic ischemic events, most commonly deep vein thrombosis, occurred in 37%. Tobacco use was documented in 85%, hyperlipidemia in 74%, hypertension in 44%, and diabetes mellitus in 7% of patients. A prominent headache history was present in 67%. Lupus anticoagulant (LA) was present in 72%, approximately one half had positive antinuclear antibodies and thrombocytopenia, and one quarter had a false-positive VDRL. We compared mean GPL levels in patients testing positive for specific laboratory features of antiphospholipid syndrome with those testing negative for these parameters. Only the LA(+) group had a significantly higher mean GPL than the LA(-) group (P=0.006). Brain imaging showed nonlacunar infarcts in 73% and lacun…

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  • The use of vitamin K antagonists over low-dose aspirin in antiphospholipid syndrome with first arterial thrombosis is supported by observational studies showing a lower likelihood of recurrent thrombosis among patients treated with vitamin K antagonists versus low-dose aspirin alone.

    “The use of VKA over LDA is supported by data from observational studies that showed a lower likelihood of recurrent thrombosis among patients with APS and prior arterial thrombosis (mainly stroke) treated with VKA versus LDA alone.31 32”

    From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [31]

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Authors
Verro, P., Levine, S. R., & Tietjen, G. E.
Affiliations
Henry Ford Health (US)
ORCID
Venue
Stroke
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1998-11
Volume
29
Issue
11
Pages
2245-2253
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
DOI
10.1161/01.str.29.11.2245
OpenAlex
W2132099411
Cited by
111
References
51
Citations by year
2025: 4 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 3 · 2020: 3 · 2019: 3 · 2017: 1 · 2016: 2 · 2015: 2 · 2014: 2 · 2013: 1 · 2012: 2
FWCI
4.30
Type
journal article
Language
en
Open access
closed
Locations
  • Stroke (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Neurological Disorders and Stroke (NS-30896, R01NS030896, NS-23393)
Topics
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Neurology › Cerebral Venous Sinus Thrombosis
Keywords
anticardiolipin antibodies, antiphospholipid syndrome, lupus anticoagulant, cerebral ischemia, cerebral infarction, recurrent ischemic events, deep vein thrombosis, prognosis, IgG antibody titers, neurological deficit, thrombocytopenia, antinuclear antibodies, VDRL test
MeSH terms
Adult, Aged, Intracranial Embolism and Thrombosis, Ischemic Attack, Transient, Cerebrovascular Disorders, Disability Evaluation, Echocardiography, Follow-Up Studies, Humans, Immunoglobulin G, Magnetic Resonance Imaging, Middle Aged, Prospective Studies, Risk Factors, Tomography, X-Ray Computed, Lupus Coagulation Inhibitor, Antibodies, Anticardiolipin

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