title: [Aspirin versus anticoagulation in young patients with cerebral infarction secondary to primary antiphospholipid syndrome].
abstract: BACKGROUND
  The primary antiphospholipid syndrome (PAS) is an independent risk factor for cerebral infarction. AIM. To evaluate the risk of recurrence, to compare different treatments and determine the risk factors associated with recurrence and hemorrhagic complications in patients with cerebral infarction and PAS.
  
  
  METHODS
  Prospectively collected data from 92 patients under 45 years (71% female, mean age 33.8 ± 8.9 years) with confirmed diagnoses of cerebral infarction and PAS, treated with anticoagulants (n = 54) or aspirin (n = 38) were retrospectively analyzed. Clinical follow-up was obtained by neurological examination every 6 to 12 months. Outcome measures were: recurrence of CI, symptomatic intracerebral hemorrhage, and minor bleeding.
  
  
  RESULTS
  During a median follow-up of 54 months (range: 12-240 months), there were 8 (9%) recurrent cerebral infarctions, with no difference between treatment with aspirin (n = 0) or anticoagulants (n = 8). The annual rate of recurrence was 0,014 person-years of follow-up. The history of previous thrombosis and spontaneous abortions were more frequent in patients with recurrence. Aspirin-treated patients more frequently came from rural areas. Four anticoagulated patients developed bleeding complications, two minor bleeding and two subdural hematomas. 76% of the cases evolved with good outcome (modified Rankin scale: 0-2).
  
  
  CONCLUSIONS
  With the limitations of a nonrandomized study, our data suggest that the risk of recurrent arterial cerebral infarction in young patients with cerebral infarction secondary to PAS is low, probably non-uniform and independent of the type of antithrombotic.
authors: Clínica de Enfermedad Vascular Cerebral, Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico. arauzg@prodigy.net.mx
authors: Antonio
authors: A
authors: Arauz
authors: Luis F
authors: LF
authors: Roa
authors: Bernardo
authors: B
authors: Hernandez
authors: Marlon
authors: M
authors: Merlos
authors: Juan M
authors: JM
authors: Marquez
authors: Carol
authors: C
authors: Artigas
authors: Aurora
authors: A
authors: Perez
authors: Carlos
authors: C
authors: Cantu-Brito
authors: Fernando
authors: F
authors: Barinagarrementeria
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000188:drug therapy*; D001241:Aspirin / Q000627:therapeutic use*; D002544:Cerebral Infarction / Q000188:drug therapy* / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin