Stroke, Vol 21, 1268-1273, Copyright © 1990 by American Heart Association
We reviewed the clinical and laboratory data of 128 patients with
cerebrovascular disease and antiphospholipid antibodies. Cases were evenly
divided between men and women, and the mean age of the study group was 46
years. Cerebral infarction occurred in 97 patients, and transient
hemispheric ischemic attacks without stroke were recorded in 19; 12
suffered ocular ischemia. Systemic lupus erythematosus was diagnosed in 16%
of all cases. Histories of systemic thromboembolic events and recurrent
miscarriages were noted in 14% of the patients and in 19% of the women,
respectively. Evidence of cerebral infarction preceding the index event was
present in 30% of cases. During a mean follow-up of 16 months, nine of 96
(9%) patients sustained new cerebral infarctions. Of 72 echocardiographic
studies, 16 (22%) showed valvular abnormalities. Cerebral angiography
detected intracranial lesions in 24 of 49 patients (49%). These data
indicate that antiphospholipid antibodies can be identified in stroke
patients without known autoimmune disorders. They also suggest that
antiphospholipid antibody- associated cerebrovascular ischemia may be
recurrent and often occurs in patients with systemic thromboembolic events.
Our findings should help design a prospective clinical trial that will
assess the risk of recurrent thromboembolism in this population, identify
stroke risk factors, and address therapy.
ARTICLES
Clinical and laboratory findings in patients with antiphospholipid antibodies and cerebral ischemia. The Antiphospholipid Antibodies in Stroke Study Group
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