Antiphospholipid antibodies in young adults with stroke.
BACKGROUND
Antiphospholipid antibodies have been associated with a clinical syndrome consisting thrombosis and recurrent, unexplained fetal loss.


METHODS
The literature pertaining to stroke associated with antiphospholipid antibodies, with emphasis on stroke in young adults, was reviewed.


RESULTS
Antiphospholipid antibodies are an independent risk factor for stroke in young adults in five of six studies. Multiple antiphospholipid specificities or the Lupus Anticoagulant were tested in addition to anticardiolipin antibody in these studies. In the single study that found no increased risk for stroke, only anticardiolipin antibody was tested. Only one of these studies evaluated for risk of recurrent stroke in young adults with antiphospholipid antibodies and found it to be increased. No treatment trials have been conducted in young adults with antiphospholipid antibodies and stroke. In the single treatment trial comparing aspirin and low-INR producing doses of warfarin to prevent recurrent stroke, both were found to be equally effective.


CONCLUSIONS
Antiphospholipid antibodies, particularly Lupus Anticoagulant, is an independent risk factor for first and possibly recurrent ischemic stroke in young adults. The best therapeutic strategy for preventing antiphospholipid antibody-associated recurrent stroke is not clear.
Brey
Robin L
RL
University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284-7883, USA. brey@uthscsa.edu
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017153:Antibodies, Anticardiolipin / Q000097:blood; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000235:genetics / Q000276:immunology / Q000628:therapy; D001241:Aspirin / Q000627:therapeutic use; D006801:Humans; D002546:Ischemic Attack, Transient / Q000097:blood / Q000276:immunology* / Q000517:prevention & control; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000097:blood / Q000276:immunology* / Q000517:prevention & control; D013927:Thrombosis / Q000276:immunology / Q000517:prevention & control; D014859:Warfarin / Q000627:therapeutic use
D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D016682:Lupus Coagulation Inhibitor; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D001241:Aspirin