Elevated Anticardiolipin Antibody Titer Is a Stroke Risk Factor in a Multiethnic Population Independent of Isotype or Degree of Positivity

Abstract

Background and Purpose-Previous studies have produced conflicting results regarding the putative association between anticardiolipin antibodies (aCL) and infarction in the general stroke population. These inconsistencies may be a function of sample size and methodological differences among the studies. The purpose of the present study, the largest case-control study of this issue to date, was to assess aCL status as an independent risk factor for ischemic stroke in a multiethnic, urban population. Odds ratios (ORs) were adjusted for age, sex, race/ethnicity, history of diabetes, hypertension, atrial fibrillation, coronary artery disease, and current cigarette smoking. Results-A positive aCL titer was present in 11% (111/1020) of controls and 34% (180/524) of cases. The adjusted OR for any positive aCL titer was 4.0 (95% CI, 3.0 to 5.5). For any positive IgG aCL titer this value was 3.9 (95% CI, 2.8 to 5.5), and for any positive IgM aCL titer it was 3.4 (95% CI, 2.1 to 5.5). There were no significant differences in ORs associated with high-or low-positive IgG or IgM aCL titers. Conclusions-In the largest study of its kind to date, aCL antibodies were demonstrated to be independent stroke risk factors across the 3 ethnic groups studied, conferring a 4-fold increased risk of ischemic stroke. IgG and for the first time IgM aCL were each shown to be associated with increased stroke risk. The prevalence of these antibodies and the stroke risk associated appear greater than previously reported. (Stroke. 1999;30:1561-1565.) Methods-We

Antibodies to the atherosclerotic plaque components beta2-glycoprotein I and heat-shock proteins as risk factors for acute cerebral ischemia

“…In the largest case-control study to date (524 cases), IgG and IgM aCL antibodies were consistently associated with risk of cerebral ischemia 27 . Brey et al, in a recent controlled study involving 259 cases of ischemic stroke, reported that IgG aCL antibodies yielded a small risk (adjusted OR 2.2) for the outcome 28 .…”

“…Being IgM an antibody of acute response, the eventual presence of this isotype aCL might represent more the result than the cause of ischemic stroke. In previous controlled studies including the IgM aCL isotype 27,28 , the OR varied from significant to trivial.…”

Treatment of Risk Factors to Prevent Stroke

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