Anticardiolipin Antibody in Elderly Ischemic Stroke

Kim, Young Jae; Park, Kee Duk; Choi, Kyoung Gyu

Abstract

BACKGROUND: Although anticardiolipin antibody(aCL)-related stroke is far more frequently identified in younger populations, the role of aCL in the pathogenesis of cerebral infarction may be important also in the old, stroke-prone population. We studied the clinical profiles of aCL- related stroke in elderly patient to look at its role on the pathogenesis of ischemic stroke.
METHODS
We analyzed unselected patients with acute ischemic stroke and age matched controls for the presence of aCL, prospectively. Also, we studied the characteristics of these patients based on the conventional risk factors and other clinical, laboratory and radiological features in them.
RESULTS
aCL was positive 30 (14.7%) of 203 stroke patients, but 11 (6.1%) in 193 control patients. The proportion of patients having more than one of the risk factors was significantly greater in aCL-positive (24/30, 80.0%) than in aCL-negative patients (100/173, 57.8%). The incidence of aCL positivity was significantly greater in patients having one or more risk factors (24/124, 19.3%) than in patients not having any of the risks (6/79, 7.6%). Two of the patients had prolonged aPTT, and only one had a lupus anticoagulant. A positive ANA and false-positive VDRL were not found in our patients. Radiological findings confer subcortical infarction.
CONCLUSION
The elevated aCL are a risk marker for stroke also in the elderly population. Our aCL-positive patients generally had multiple risk factors for stroke and are associated with subcortical infarctions, contrary to previous studies. The role of aCL as a disease marker for ischemic stroke in elderly patients warrants further investigations.