Robin L Brey1. 1. University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284-7883, USA. brey@uthscsa.edu
Abstract
BACKGROUND: Antiphospholipid antibodies have been associated with a clinical syndrome consisting thrombosis and recurrent, unexplained fetal loss. METHODS: The literature pertaining to stroke associated with antiphospholipid antibodies, with emphasis on stroke in young adults, was reviewed. RESULTS: Antiphospholipid antibodies are an independent risk factor for stroke in young adults in five of six studies. Multiple antiphospholipid specificities or the Lupus Anticoagulant were tested in addition to anticardiolipin antibody in these studies. In the single study that found no increased risk for stroke, only anticardiolipin antibody was tested. Only one of these studies evaluated for risk of recurrent stroke in young adults with antiphospholipid antibodies and found it to be increased. No treatment trials have been conducted in young adults with antiphospholipid antibodies and stroke. In the single treatment trial comparing aspirin and low-INR producing doses of warfarin to prevent recurrent stroke, both were found to be equally effective. CONCLUSIONS: Antiphospholipid antibodies, particularly Lupus Anticoagulant, is an independent risk factor for first and possibly recurrent ischemic stroke in young adults. The best therapeutic strategy for preventing antiphospholipid antibody-associated recurrent stroke is not clear.
BACKGROUND: Antiphospholipid antibodies have been associated with a clinical syndrome consisting thrombosis and recurrent, unexplained fetal loss. METHODS: The literature pertaining to stroke associated with antiphospholipid antibodies, with emphasis on stroke in young adults, was reviewed. RESULTS: Antiphospholipid antibodies are an independent risk factor for stroke in young adults in five of six studies. Multiple antiphospholipid specificities or the Lupus Anticoagulant were tested in addition to anticardiolipin antibody in these studies. In the single study that found no increased risk for stroke, only anticardiolipin antibody was tested. Only one of these studies evaluated for risk of recurrent stroke in young adults with antiphospholipid antibodies and found it to be increased. No treatment trials have been conducted in young adults with antiphospholipid antibodies and stroke. In the single treatment trial comparing aspirin and low-INR producing doses of warfarin to prevent recurrent stroke, both were found to be equally effective. CONCLUSIONS: Antiphospholipid antibodies, particularly Lupus Anticoagulant, is an independent risk factor for first and possibly recurrent ischemic stroke in young adults. The best therapeutic strategy for preventing antiphospholipid antibody-associated recurrent stroke is not clear.
Authors: Steven R Levine; Robin L Brey; Barbara C Tilley; J L P Thompson; Ralph L Sacco; Robert R Sciacca; A Murphy; Yimeng Lu; Teresa M Costigan; Candi Rhine; Bruce Levin; Douglas A Triplett; J P Mohr Journal: JAMA Date: 2004-02-04 Impact factor: 56.272
Authors: Ricard Cervera; Munther A Khamashta; Josep Font; Gian Domenico Sebastiani; Antonio Gil; Paz Lavilla; Juan Carlos Mejía; A Olcay Aydintug; Hanna Chwalinska-Sadowska; Enrique de Ramón; Antonio Fernández-Nebro; Mauro Galeazzi; Merete Valen; Alessandro Mathieu; Frédéric Houssiau; Natividad Caro; Paula Alba; Manuel Ramos-Casals; Miguel Ingelmo; Graham R V Hughes Journal: Medicine (Baltimore) Date: 2003-09 Impact factor: 1.889
Authors: Tamer Yahya; Mohammad Hashim Jilani; Safi U Khan; Reed Mszar; Syed Zawahir Hassan; Michael J Blaha; Ron Blankstein; Salim S Virani; Michelle C Johansen; Farhaan Vahidy; Miguel Cainzos-Achirica; Khurram Nasir Journal: Am J Prev Cardiol Date: 2020-09-09