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.

中文翻译：

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缺血性抗磷脂综合征的危险因素：病例对照研究

客观的

本研究的目的是确定原发性抗磷脂综合征 (APS) 患者缺血性卒中 (IS) 的临床和实验室危险因素。

材料和方法

我们进行了一项病例对照研究，将连续的原发性 APS 患者分为两组，即患有 IS 的患者与没有中风病史的患者。记录人口统计学、血管危险因素、治疗方法、实验室、影像学和功能结果。

结果

招募了 53 名确诊为 IS 的原发性 APS 患者和 66 名非中风原发性 APS 对照。大多数患者为女性（65.5%），中位年龄为 33 岁。原发性 APS 相关卒中的主要血管危险因素是高血压 (11.3 %)、糖尿病 (11.3 %) 和高胆固醇血症 (9.4 %)。在中风患者中，NIHSS 评分中位数为 6；这些患者中有 15.1% 出现复发性卒中，88.8% 在最终随访时功能结果良好。狼疮抗凝剂 (OR = 6.1, 95 %CI 2.7–13.5)、抗 β2 糖蛋白 IgG (OR = 3.6, 95 %CI 1.7–7.9) 和抗心磷脂 IgG (OR = 2.8, 95 %CI 1.3–5.9)在非卒中原发性 APS 中更为普遍，46.4 % 的对照组和 22.2 % 的卒中患者存在三阳性抗体（OR = 3.0, 95 % CI 1.3–6.7）。

结论

与颅外血栓形成患者相比，原发性 APS 和 IS 患者具有相似的血管危险因素和较低的抗体阳性。