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Subsequent Thrombotic Outcomes in Patients with Ischemic Stroke with Antiphospholipid Antibody Positivity.

 Jung Yoon Pyo  ;  Seung Min Jung  ;  Sang-Won Lee  ;  Jason Jungsik Song  ;  Soo-Kon Lee  ;  Yong-Beom Park 
 Yonsei Medical Journal, Vol.58(6) : 1128-1134, 2017 
Journal Title
 Yonsei Medical Journal 
Issue Date
Antibodies, Antiphospholipid/blood* ; Antibodies, Antiphospholipid/immunology* ; Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/immunology ; Female ; Humans ; Kaplan-Meier Estimate ; Lupus Coagulation Inhibitor/blood ; Male ; Middle Aged ; Proportional Hazards Models ; Recurrence ; Stroke/complications ; Stroke/epidemiology* ; Stroke/immunology ; Stroke/prevention & control ; Thrombosis/complications ; Thrombosis/immunology* ; Thrombosis/prevention & control ; beta 2-Glycoprotein I/immunology
Antiphospholipid antibody ; persistence ; recurrence ; stroke ; titer
PURPOSE: International consensus criteria for antiphospholipid syndrome (APS) require persistently positive antiphospholipid antibodies (aPL) and medium or high titers in association with clinical manifestations. However, the clinical relevance of persistence and titers of aPL in patients with stroke has not been identified. We aimed to investigate the risk of subsequent thrombotic events in patients with ischemic stroke with aPL positivity in terms of aPL status. MATERIALS AND METHODS: We reviewed the medical records of 99 patients with ischemic stroke with at least one or more aPL-positivity (i.e., positivity for aCL, anti-β2-glycoprotein-1, and/or lupus anticoagulants). The patients were divided into two groups: "definite APS" who fulfilled the laboratory criteria and "indefinite APS" who fell short of the criteria. We compared the risk of subsequent thrombotic events between the two groups. Cox proportional hazards model and Kaplan-Meier survival curves were used for the analyses. RESULTS: Of the 99 patients, 46 (46%) were classified as having definite APS and 53 (54%) as having indefinite APS. The mean follow-up was 51.6 months. Overall event numbers were 14 (30.4%) in definite APS and 16 (30.2%) in indefinite APS. Increased subsequent thrombotic events (hazard ratio 1.039; 95% confidence interval 0.449-2.404; p=0.930) and decreased time to thrombotic events (log-rank p=0.321) were not associated with aPL status. CONCLUSION: There was no increased risk of subsequent thrombotic events in ischemic stroke patients with definite APS, compared with those with indefinite APS.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박용범(Park, Yong Beom)
송정식(Song, Jungsik Jason) ORCID logo https://orcid.org/0000-0003-0662-7704
이상원(Lee, Sang Won)
정승민(Jung, Seung Min ) ORCID logo https://orcid.org/0000-0003-3465-2181
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