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Cerebrovascular Ischemic Events With High Positive Anticardiolipin Antibodies
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 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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Metadata
- Authors
- Verro, P., Levine, S. R., & Tietjen, G. E.
- Affiliations
- Henry Ford Health (US)
- Venue
- Stroke
- Published
- 1998-11
- Volume
- 29
- Issue
- 11
- Pages
- 2245-2253
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- 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 › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Clinical 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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