Risk factors for ischemic antiphospholipid syndrome: A case-control study

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Les compartimos el artículo de Risk factors for ischemic antiphospholipid syndrome: A case-control study en el que participaron los siguientes doctores: Dra. Vanessa Cano, Dr. Antonio Arauz, Dra. Roxana Matus, Dra. Ana Barrera-Vargas, Dra. Marina Rull-Gabayet, Dr. Eduardo Aguirre-Aguilar, Dr. Martín Valdez-López, Dr. Fernando Espinoza-Lira, Dra. Cristina Ramos-Ventura, Dr. Miguel A. Barboza, Dr. Javier Merayo-Chalico. Les compartimos el Abstract del artículo, así como la liga donde podrá ser consultado en su totalidad.

Risk factors for ischemic antiphospholipid syndrome: A case-control study

Clinical Neurology and Neurosurgery
Roxana Matus-Mayorga a, Ana Barrera-Vargas b, Marina Rull-Gabayet b, Eduardo Aguirre-Aguilar b, Martín Valdez-L´opez b, Fernando Espinoza-Lira a, Cristina Ramos-Ventura a, Vanessa Cano-Nigenda a, Miguel A. Barboza a,c, Javier Merayo-Chalico b,*, Antonio Arauz a 

a Stroke Clinic, Instituto Nacional de Neurologia y Neurocirugia, Manuel Velasco Suarez, Mexico City, Mexico
b Immunology and Rheumatology Department, Instituto Nacional de Ciencias M´edicas y Nutrici´on Salvador Zubir´an, Mexico City, Mexico
c Neurosciences Department, Hospital Dr Rafael A. Calder´on Guardia, CCSS, San Jose, Costa Rica.
Received 13 November 2020; Received in revised form 30 December 2020; Accepted 11 January 2021, Available online 15 January 2021 /https://doi.org/10.1016/j.clineuro.2021.106492 / 0303-8467/© 2021 Elsevier B.V. All rights reserved.


Objective: The objective of this study was to identify clinical and laboratory risk factors for ischemic stroke (IS) in primary antiphospholipid syndrome (APS) patients.
Materials and Methods: We performed a case-control study with consecutive primary APS patients divided into two groups, those who presented with IS, vs. those with no history of stroke. Demographics, vascular risk factors, therapeutic approaches, laboratory, imaging and functional outcomes were recorded.
Results: Fifty-three confirmed primary APS patients with IS and sixty-six non-stroke primary APS controls were recruited. Most patients were female (65.5 %), with a median age of 33 years. The main vascular risk factors for primary APS-associated stroke were hypertension (11.3 %), diabetes (11.3 %) and hypercholesterolemia (9.4 %).
Among patients with stroke, median NIHSS score was 6; 15.1 % of these patients presented a recurrent stroke, and 88.8 % had a good functional outcome at the final follow-up. Positive lupus anticoagulant (OR = 6.1, 95 %CI 2.7–13.5), anti-β2 glycoprotein IgG (OR = 3.6, 95 %CI 1.7–7.9), and anticardiolipin IgG (OR = 2.8, 95 %CI 1.3–5.9) were more prevalent in non-stroke primary APS, with a triple-positive antibody presence in 46.4 % of controls vs. 22.2 % of patients with stroke (OR = 3.0, 95 %CI 1.3–6.7). At the time of the index event (arterial or venous), 14 known primary APS patients were using vitamin K antagonists, but only 35.7 % of them had achieved therapeutic INR.
Conclusion: Patients with primary APS and IS have similar vascular risk factors and lower antibody positivity than those with extracranial thrombosis.

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