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From the Center for Stroke Research, Departments of Neurology (Drs. D'Olhaberriague, Levine, Salowich-Palm, Tanne, Sawaya, Aurora, Perry, and Day) and Biostatistics and Research Epidemiology (Drs. Spencer and Schultz), Henry Ford Health Sciences Center and Henry Ford Hospital, Detroit Campus of Case Western Reserve University, Detroit, MI.
Address correspondence and reprint requests to Dr. Steven R. Levine, Director, Wayne State University/Detroit Medical Center Stroke Program, WSU School of Medicine, University Health Center, 6E, 4201 Saint Antoine, Detroit, MI 48201.
Background and purpose: There is an association between anticardiolipin antibodies (aCL) and ischemic stroke. There are, however, also occasional reports linking aCL with other CNS diseases (OND), particularly with multiple sclerosis (MS). Hence, we studied the specificity of aCL for ischemic stroke.
Methods: Prospective, consecutively identified patients evaluated for aCL (immunoglobulin G [IgG] and immunoglobulin M [IgM] isotypes) were divided into two groups: ischemic stroke (first ever) and OND (stroke-free subjects affected by OND).
Results: The ischemic stroke group (n = 300) and the OND (n = 149) differed in the following risk factors: age (64 ± 14 versus 58 ± 15 years; p < 0.001) and proportions of African Americans (67% versus 29%; p < 0.001); current cigarette smoker (26% versus 17%; p = 0.028); hypertensive (69% versus 34%; p < 0.001); diabetic (18% versus 7%; p = 0.001); history of angina (16% versus 8%; p = 0.015) or myocardial infarction (15% versus 3%; p < 0.001). There were higher rates of aCL positivity (26% versus 17%; p = 0.050), IgG-aCL > 10 GPL (23% versus 11%; p = 0.003) or IgG aCL > 20 GPL (12% versus 4%; p = 0.012) among the stroke group than among the OND group. No differences in IgG-aCL positivity were found between the MS group and the rest of the OND group but the MS patients had a higher rate of IgM-aCL positivity than the other OND patients.
Conclusion: IgG-aCL positivity does not appear to be a marker for CNS disease generally but of ischemic stroke.
Supported in part by NIH grants NS 30896 and NS 23393 and the American Heart Association, Michigan Affiliate (grant-in-aid). L. D'Olhaberriague is recipient of a "Junior Javits" NIH fellowship.
Received May 6, 1998. Accepted in final form August 1, 1998.
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