Anti-cardiolipin antibodies and overall survival in a large cohort: preliminary report.
BACKGROUND
Anti-cardiolipin antibodies have been associated with both arterial and venous thrombosis, but their overall impact on all-cause or vascular mortality is unknown. In this study, we evaluated the influence of anti-cardiolipin antibodies on all-cause and vascular mortality.


METHODS
All individuals who fulfilled the inclusion criteria (completeness of data, no admission from an intensive care unit, unique identification with name and date of birth) and whose anti-cardiolipin antibodies were measured between October 2002 and February 2004 were included in this study (n = 4756; 64% female; median age, 46 years). Death/survival and cause of death were obtained from the Austrian Death Registry. The median observation period was 1.5 years, and the study comprised 7189 person-years.


RESULTS
During the study period, 184 patients (3.9%) died. There were no associations between either anti-cardiolipin IgM or IgG antibodies and both vascular death and noncancer mortality as outcome variables in a Cox regression analysis adjusted for age and sex. In contrast, the risk of cancer-related mortality was increased 2.6-fold.


CONCLUSIONS
Anti-cardiolipin antibodies are associated with cancer mortality, likely as an epiphenomenon of malignancy, but they are not predictive of vascular mortality or noncancer mortality. Hence, although a clear association between anti-cardiolipin antibodies and (mostly nonfatal) vascular events has been described in the literature, our data indicate that this finding is not necessarily associated with an increase in vascular mortality.
Institute of Medical and Chemical Laboratory Diagnostics, Department of Clinical Pharmacology, Division of Haematology and Immunology, Medical University of Vienna, Vienna, Austria.
Georg
G
Endler
Claudia
C
Marsik
Bernd
B
Jilma
Thomas
T
Schickbauer
Rainer
R
Vormittag
Oswald
O
Wagner
Christine
C
Mannhalter
Helmut
H
Rumpold
Ingrid
I
Pabinger
D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D002308:Cardiolipins / Q000276:immunology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012306:Risk; D015996:Survival Rate; D014652:Vascular Diseases / Q000276:immunology / Q000401:mortality
D001323:Autoantibodies; D002308:Cardiolipins