Was Antiphospholipid Syndrome a Risk Factor of Stroke? A Systemic Review and Meta-Analysis of Cohort Studies

Zhao, Kai; Zhou, Ping; Xu, Ling; Li, Ruili; Yang, Jincai; Qiang, Zhang; Yang, Mei; Wei, Xuedong

doi:10.1155/2021/4431907

Cited by 3 publications

(2 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, both CeAD and antiphospholipid syndrome are classified together in the rare cause category. However, antiphospholipid syndrome has been associated with a lifetime increased risk of venous and arterial thrombosis, whereas we have shown that patients with CeAD only have a short-term higher risk of recurrent stroke . Thus, 1 category of the TOAST classification contains multiple causes that are studied together but differ highly in terms of prognosis and appropriate secondary prevention strategies.…”

Section: Discussionmentioning

confidence: 92%

“…However, antiphospholipid syndrome has been associated with a lifetime increased risk of venous and arterial thrombosis, whereas we have shown that patients with CeAD only have a short-term higher risk of recurrent stroke. 28 , 29 , 30 Thus, 1 category of the TOAST classification contains multiple causes that are studied together but differ highly in terms of prognosis and appropriate secondary prevention strategies. This indicates that if we want to investigate the prognosis on a more individual level for young patients with ischemic stroke, the current cause classification system might not suffice, and we need to identify and study subtypes of causes in more detail.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Short-Term and Long-Term Risk of Recurrent Vascular Event by Cause After Ischemic Stroke in Young Adults

Verburgt,

Hilkens,

Ekker

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceCause of ischemic stroke in young people is highly variable; however, the risk of recurrence is often presented with all subtypes of stroke grouped together in classification systems such as the Trial of ORG (danaparoid sodium [Orgaran]) 10172 in Acute Stroke Treatment (TOAST) criteria, which limits the ability to individually inform young patients with stroke about their risk of recurrence.ObjectiveTo determine the short-term and long-term risk of recurrent vascular events after ischemic stroke at a young age by stroke cause and to identify factors associated with recurrence.Design, Setting, and ParticipantsThis cohort study used data from the Observational Dutch Young Symptomatic Stroke Study, a prospective, multicenter, hospital-based cohort study, conducted at 17 hospitals in the Netherlands between 2013 and 2021. Eligible participants included 30-day survivors of an initial, neuroimaging-proven ischemic stroke (aged 18-49 years). Data analysis was conducted from June to July 2023.ExposureDiagnosis of a first-ever, ischemic stroke via neuroimaging.Main Outcome and MeasuresThe primary outcome was short-term (within 6 months) and long-term (within 5 years) recurrence risk of any vascular event, defined as fatal or nonfatal recurrent ischemic stroke, transient ischemic attack, myocardial infarction, and revascularization procedure. Predefined characteristics were chosen to identify factors associated with risk of recurrence (cause of stroke, age, sex, stroke severity, and cardiovascular health factors).ResultsA total of 1216 patients (median [IQR] age, 44.2 [38.4-47.7] years; 632 male [52.0%]; 584 female [48.0%]) were included, with a median (IQR) follow-up of 4.3 (2.6-6.0) years. The 6-month risk of any recurrent ischemic event was 6.7% (95% CI, 5.3%-8.1%), and the 5-year risk was 12.2% (95% CI, 10.2%-14.2%)The short-term risk was highest for patients with cervical artery dissections (13.2%; 95% CI, 7.6%-18.7%). Other factors associated with a recurrent short-term event were atherothrombotic stroke, rare causes of stroke, and hypertension. The long-term cumulative risk was highest for patients with atherothrombotic stroke (22.7%; 95% CI, 10.6%-34.7%) and lowest for patients with cryptogenic stroke (5.8%; 95% CI, 3.0%-8.5%). Cardioembolic stroke was associated with a recurrent long-term event, as were diabetes and alcohol abuse.Conclusions and RelevanceThe findings of this cohort study of 1216 patients with an ischemic stroke at a young age suggest that the risk of recurrent vascular events was high and varied by cause of stroke both for short-term and long-term follow-up, including causes that remained concealed when combined into 1 category in the routinely used TOAST criteria. This knowledge will allow for more personalized counseling of young patients with stroke.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Short-Term and Long-Term Risk of Recurrent Vascular Event by Cause After Ischemic Stroke in Young Adults

Verburgt,

Hilkens,

Ekker

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

Neurological Impairment Caused by Rheumatoid Arthritis Complicated with Sjogren’s Syndrome Secondary to Antiphospholipid Antibody Syndrome: A Case Report and Literature Review

唐

2024

ACM

View full text Add to dashboard Cite

Antiphospholipid Syndrome Increases Postoperative Complications After Total Hip and Knee Arthroplasty

Hirpara,

Carpenter,

Dayton

et al. 2024

Orthopedics

View full text Add to dashboard Cite

Background: Antiphospholipid syndrome (APS) is a systemic autoimmune condition that predisposes patients to venous thromboembolism (VTE). Although many studies have explored risk factors for VTE after joint reconstructive procedures, the impact of APS is still unclear. Materials and Methods: A retrospective cohort study was conducted using TriNetX, a health care database that includes 442,494 patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). Ninety-day postoperative complications and 1- and 2-year surgical complications were compared between patients with and without preexisting APS. Patients underwent propensity score matching in a 1:1 ratio based on relevant comorbidities. Results: Patients undergoing THA or TKA with APS, compared with those without, had higher rates of deep venous thrombosis (hip: 9.2% vs 6.0%, odds ratio, 1.589, P =.022; knee: 10.5% vs 4.1%, odds ratio, 2.763, P <.001), pulmonary embolism (hip: 6.9% vs 3.6%, odds ratio, 1.992, P =.005; knee: 8.4% vs 3.0%, odds ratio, 2.989, P <.001), and anemia (hip: 24.8% vs 18.6%, odds ratio, 1.447, P =.004; knee: 18.5% vs 13.9%, odds ratio, 1.406, P =.007). Patients undergoing THA with APS also had higher rates of urinary tract infection (5.0% vs 2.8%, odds ratio, 1.842, P =.029) and pneumonia (3.7% vs 1.8%, odds ratio, 2.119, P =.025). APS did not impact rates of surgical complications or revision surgery. Conclusion: Overall, APS heightens patients' risk for complications after THA and TKA. Specific anticoagulation protocols and preoperative risk stratification should be implemented to reduce the risk of adverse events. [ Orthopedics . 202;4x(x):xx–xx.]

show abstract

Was Antiphospholipid Syndrome a Risk Factor of Stroke? A Systemic Review and Meta-Analysis of Cohort Studies

Cited by 3 publications

References 29 publications

Short-Term and Long-Term Risk of Recurrent Vascular Event by Cause After Ischemic Stroke in Young Adults

Short-Term and Long-Term Risk of Recurrent Vascular Event by Cause After Ischemic Stroke in Young Adults

Neurological Impairment Caused by Rheumatoid Arthritis Complicated with Sjogren’s Syndrome Secondary to Antiphospholipid Antibody Syndrome: A Case Report and Literature Review

Antiphospholipid Syndrome Increases Postoperative Complications After Total Hip and Knee Arthroplasty

Contact Info

Product

Resources

About