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Stroke and antiphospholipid syndrome—antiphospholipid antibodies are a risk factor for an ischemic cerebrovascular event

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Abstract

Testing for antiphospholipid antibodies could be an important part in determining the cause of a cerebrovascular event (CVE). Currently, it is also unknown whether antiphospholipid antibodies represent a risk factor for the development of a CVE and whether the selected therapy options are efficacious. So, this study aimed at (1) determining the frequency of patients experiencing a CVE and fulfilling the laboratory criterion for an antiphospholipid syndrome (APS), (2) investigating whether the persistent presence of antiphospholipid antibodies represented a risk factor for a CVE, and (3) focusing on the efficacy of the selected treatment strategy in the first year after the CVE. Eighty-nine patients with an acute CVE were prospectively followed for 1 year. At least two sera from each were tested for lupus anticoagulants, anticardiolipin, anti-β2-glycoprotein I, anti-phosphatidylserine/prothrombin and anti-annexin V antibodies. Twenty out of eighty-nine (22%) of CVE patients fulfilled the criteria for APS (17/20 for definitive and 3 for probable APS). There was a significant association between persistently present antiphospholipid antibodies and the CVE (OR, 4.62). No statistically significant difference was found in the CVE recurrence rate between APS-CVE and non-APS-CVE patients being treated mainly with acetyl salicylic acid. Antiphospholipid antibodies represent an independent risk factor for a CVE. In the first year after the CVE, antiplatelet therapy seemed to be sufficient in secondary CVE thromboprophylaxis in most APS patients.

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Funding

The study was supported by the Slovenian Research Agency (ARRS) for the National Research Programme (P3-0314).

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Authors and Affiliations

  1. Department of Rheumatology, University Medical Centre Ljubljana, Vodnikova 62, SI-1000, Ljubljana, Slovenia

    Nataša Gašperšič, Polona Žigon, Saša Čučnik, Snežna Sodin Šemrl, Matija Tomšič & Aleš Ambrožič

  2. Department of Neurology, University Medical Centre Ljubljana, Zaloška 2, SI-1000, Ljubljana, Slovenia

    Marjan Zaletel & Jan Kobal

  3. Faculty of Pharmacy, University of Ljubljana, Aškerčeva 7, SI-1000, Ljubljana, Slovenia

    Saša Čučnik

  4. Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Glagoljaška 8, SI-6000, Koper, Slovenia

    Snežna Sodin Šemrl

  5. Faculty of Medicine, University of Ljubljana, Vrazov trg 2, SI-1104, Ljubljana, Slovenia

    Matija Tomšič

Authors
  1. Nataša Gašperšič
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  2. Marjan Zaletel
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  3. Jan Kobal
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  4. Polona Žigon
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  5. Saša Čučnik
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  7. Matija Tomšič
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  8. Aleš Ambrožič
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Correspondence to Nataša Gašperšič.

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The study was approved by the Slovene National Medical Ethics Committee (163/02/09).

Additional information

Rheumatology in Slovenia: Clinical practice and translational research

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Gašperšič, N., Zaletel, M., Kobal, J. et al. Stroke and antiphospholipid syndrome—antiphospholipid antibodies are a risk factor for an ischemic cerebrovascular event. Clin Rheumatol 38, 379–384 (2019). https://doi.org/10.1007/s10067-018-4247-3

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  • DOI: https://doi.org/10.1007/s10067-018-4247-3

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