High titer of anticardiolipin antibody is associated with first-ever ischemic stroke in Taiwan.
OBJECTIVE
The association between anticardiolipin antibody (aCL) and ischemic stroke is controversial, and there are few case-control studies of Asian populations. The aim of this study, therefore, was to determine whether aCL is an independent risk factor for ischemic stroke in Taiwanese patients over the age of 40 years.


METHODS
Both the IgG and IgM isotypes of aCL were measured in 273 patients (> 40 years of age) hospitalized for first-ever ischemic stroke and in 181 non-stroke controls. Results were defined as: negative (< 10 IgG phospholipid units [GPL] or < 7.5 IgM phospholipid units [MPL]); low positive (10-20 GPL or 7.5-15 MPL); or, high positive (> 20 GPL or > 15 MPL). Odds ratios (OR) were estimated by logistic regression with adjustment for potential confounders.


RESULTS
A high positive IgG aCL was present in 4.4% of the stroke patients and 1.2% of the controls. Age- and sex-adjusted analysis showed a borderline association between a high positive level for aCL IgG titer and stroke, with an OR of 4.01 (95% CI 0.87-18.37; p = 0.0739). Final analysis, with adjustments for age, sex, hypertension, diabetes, tobacco smoking, atrial fibrillation, left ventricular hypertrophy and hyperlipidemia, revealed an OR of 5.25 (95% CI 1.06-25.89; p = 0.0419).


CONCLUSIONS
The results of this study suggest that elevated titer of aCL IgG (> 20 GPL) is associated with first-ever ischemic stroke in Taiwanese patients aged over 40 years. High positive aCL titer is related to ischemic stroke after adjustment for conventional cerebrovascular risk factors, indicating that it is probably an independent risk factor for ischemic stroke.
Lien
Li-Ming
LM
Department of Neurology, Shin Kong WHS Memorial Hospital, Taipei, Taiwan.
Chen
Wei-Hung
WH
Chiu
Hou-Chang
HC
Pan
Wen-Harn
WH
Chen
Jiunn-Rong
JR
Bai
Chyi-Huey
CH
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D002545:Brain Ischemia / Q000209:etiology / Q000276:immunology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000276:immunology*; D013624:Taiwan
D017153:Antibodies, Anticardiolipin