Elevated anticardiolipin antibody titer is a stroke risk factor in a multiethnic population independent of isotype or degree of positivity.
Elevated anticardiolipin antibody titer is a stroke risk factor in a multiethnic population independent of isotype or degree of positivity.
复制标题
抗心磷脂抗体滴度升高是多种族人群中的卒中危险因素，与同种型或阳性程度无关。
DOI：
10.1161/01.str.30.8.1561
复制
发表时间：
1999
期刊：
影响因子：
8.3
通讯作者：
Godbold,JH
中科院分区：
文献类型：
--
作者：
Tuhrim,S;Rand,JH;Wu,XX;Weinberger,J;Horowitz,DR;Goldman,ME;Godbold,JH
背景和目的：以往的研究对于抗心磷脂抗体（aCL）与一般卒中人群中梗死之间的假定相关性产生了相互矛盾的结果。这些不一致性可能是样本量和研究方法差异的函数。本研究的目的，这一问题的最大的病例对照研究，到目前为止，是评估ACL状态作为一个独立的危险因素缺血性中风在多民族，城市population. Methods，我们获得了ACL滴度在524住院急性中风患者和1020社区控制参加少数民族危险因素和中风研究。结果被解释为阴性（≤22.9 IgG磷脂[GPL]或10.9 IgM磷脂[MPL]单位）、低阳性（22.9至30.0 GPL或10.9至15.0 MPL单位）或高阳性（>30.0 GPL或15.0 MPL单位）。优势比（OR）进行了调整的年龄，性别，种族/民族，糖尿病史，高血压，心房颤动，冠状动脉疾病，和当前的吸烟。结果，阳性ACL滴度存在于11%（111/1020）的控制和34%（180/524）的情况下。任何阳性aCL滴度的校正OR为4.0（95% CI，3.0 - 5.5）。对于任何阳性IgG aCL滴度，该值为3.9（95% CI，2.8至5.5），对于任何阳性IgM aCL滴度，该值为3.4（95% CI，2.1至5.5）。与高或低阳性IgG或IgM ACL titeres. Conclusions，在最大的同类研究中，迄今为止，ACL抗体被证明是独立的中风危险因素，在3个种族群体的研究，赋予4倍增加缺血性中风的风险OR无显着差异。IgG和IgM aCL首次被证明与卒中风险增加相关。这些抗体的患病率和相关的中风风险似乎比以前报道的要高。
Background and Purpose—Previous studies have produced conflicting results regarding the putative association between anticardiolipin antibodies (aCL) and infarction in the general stroke population. These inconsistencies may be a function of sample size and methodological differences among the studies. The purpose of the present study, the largest case-control study of this issue to date, was to assess aCL status as an independent risk factor for ischemic stroke in a multiethnic, urban population.Methods—We obtained aCL titers in 524 hospitalized acute stroke patients and 1020 community controls enrolled in the Minorities Risk Factors and Stroke Study. The results were interpreted as negative (≤22.9 IgG phospholipid [GPL] or 10.9 IgM phospholipid [MPL] units), low positive (22.9 to 30.0 GPL or 10.9 to 15.0 MPL units), or high positive (>30.0 GPL or 15.0 MPL units). Odds ratios (ORs) were adjusted for age, sex, race/ethnicity, history of diabetes, hypertension, atrial fibrillation, coronary artery disease, and current cigarette smoking.Results—A positive aCL titer was present in 11% (111/1020) of controls and 34% (180/524) of cases. The adjusted OR for any positive aCL titer was 4.0 (95% CI, 3.0 to 5.5). For any positive IgG aCL titer this value was 3.9 (95% CI, 2.8 to 5.5), and for any positive IgM aCL titer it was 3.4 (95% CI, 2.1 to 5.5). There were no significant differences in ORs associated with high- or low-positive IgG or IgM aCL titers.Conclusions—In the largest study of its kind to date, aCL antibodies were demonstrated to be independent stroke risk factors across the 3 ethnic groups studied, conferring a 4-fold increased risk of ischemic stroke. IgG and for the first time IgM aCL were each shown to be associated with increased stroke risk. The prevalence of these antibodies and the stroke risk associated appear greater than previously reported.