(Stroke. 2001;32:1701.)
© 2001 American Heart Association, Inc.
Original Contributions |
ß2-Glycoprotein 1–Dependent Anticardiolipin Antibodies and Risk of Ischemic Stroke and Myocardial Infarction
The Honolulu Heart Program
From the Division of Neurology (R.L.B., C.L.S.), University of Texas Health Science Center at San Antonio; the Division of Biostatistics (R.D.A.), University of Virginia School of Medicine, Charlottesville; the Department of Medicine (R.D.A., J.D.C., G.W.R.), John A. Burns School of Medicine, University of Hawaii, the Honolulu Heart Program (R.D.A., J.D.C., G.W.R.), Kuakini Medical Center, and the Honolulu Department of Veterans Affairs (G.W.R.), Honolulu, Hawaii; the National Heart, Lung, and Blood Institute (D.S.S.), Bethesda, Md; and the Department of Neurology (S.J.K.), University of Maryland School of Medicine, and the Department of Epidemiology and Preventative Medicine (S.J.K.), the Geriatrics Research, Education and Clinical Center, Baltimore Department of Veteran’s Affairs Medical Center, Baltimore, Md.
Correspondence to Steven J. Kittner, MD, MPH, Department of Neurology, Box 175, University of Maryland School of Medicine, 22 South Greene St, Baltimore, MD 21201-1595. E-mail skittner{at}umaryland.edu
Background—— It has been hypothesized that immunoreactivity to ß2-glycoprotein 1 (ß2GP1)-dependent anticardiolipin antibody (aCL), but not ß2GP1-independent aCL, is associated with increased risk of ischemic stroke and myocardial infarction (MI).
Methods—— We performed a nested case-control study examining aCL as a risk factor for ischemic stroke and MI by using stored frozen sera obtained from subjects enrolled in the Honolulu Heart Program and followed for up for 20 years. We measured ß2GP1-dependent and ß2GP1-independent aCL and anti-ß2GP1 immunoreactivity in 259 men who developed an ischemic stroke, in 374 men who developed an MI, and in a control group of 1360 men who remained free of both conditions.
Results—— Only ß2GP1-dependent aCL of the IgG class was significantly associated with both incident ischemic stroke and MI. This association was attenuated in the last 5 years of the 20-year follow-up. For stroke, the risk factor–adjusted relative odds for men with a positive versus a negative ß2GP1-dependent aCL of the IgG class were 2.2 (95% CI 1.5 to 3.4) at 15 years and 1.5 (95% CI 1.0 to 2.3) at 20 years. For MI, the adjusted relative odds were 1.8 (95% CI 1.2 to 2.6) at 15 years and 1.5 (95% CI 1.1 to 2.1) at 20 years.
Conclusions—— These data suggest that aCL IgG, particularly the ß2GP1-dependent variety, is an important predictor of future stroke and MI in men.
Key Words: antibodies, anticardiolipin • case-control studies • cerebrovascular disorders • myocardial infarction • prospective studies • risk factors
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