title: Association between non-thrombotic neurological and cardiac manifestations in patients with antiphospholipid syndrome.
abstract: OBJECTIVE
  The aim of this study was to investigate the association between non-thrombotic neurological and cardiac manifestations in patients with antiphospholipd syndrome (APS), as well as their connection with type and level of antiphospholipid antibodies.
  
  
  METHODS
  Our prospective study comprises 333 patients: 218 with primary and 115 with secondary APS. Antiphospholipid antibody (aPL) analysis included detection of aCL(IgG/IgM), ß2GPI(IgG/IgM) and LA and served to evaluate associations with distinct neurological manifestations.
  
  
  RESULTS
  The presence of aCL IgG was more common (p=0.001) in SAPS and LA in PAPS patients (p=0.002). High ß2GPI IgM levels (>100PLU/ml) were more common in epilepsy (p=0.00001) in PAPS, and in transient ischaemic attack (p=0.029) in SAPS. High ß2GPI IgG levels (>100PLU/ml) were more common in epilepsy (p=0.035) in SAPS. Chorea, migraine and epilepsy occurred more often in SAPS and headache and depression in PAPS. We found statistical significance considering the presence of aCL IgG and acute ischaemic encephalopathy in SAPS, aCL IgM and epilepsy in SAPS, aCL IgM and migraine in PAPS, ß2GPI IgG and chorea in SAPS and ß2GPI IgM and TIA and epilepsy in PAPS. LA was linked to depression, transient global amnaesia and migraine in PAPS. Patients with non-stable angina pectoris were more likely to develop TIA in both PAPS and SAPS, epilepsy and transient global amnaesia in PAPS and acute ischaemic encephalopathy in SAPS. Patients with valve vegetations were more prone to epilepsy and depression.
  
  
  CONCLUSIONS
  Certain aPL type and levels are associated with distinct neurological non-thrombotic manifestation, suggesting their predictive role. There is strong link between some non-thrombotic neurological and cardiac manifestations in APS patients, suggesting the complexity and evolutionary nature of APS.
authors.affiliation: Internal Medicine, "Bezanijska Kosa" University Medical Centre, Belgrade, Serbia. ljudmila_stojanovich@yahoo.com.
authors.forename: Ljudmila
authors.initials: L
authors.lastname: Stojanovich
authors.forename: Milica
authors.initials: M
authors.lastname: Kontic
authors.forename: Dusica
authors.initials: D
authors.lastname: Smiljanic
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Djokovic
authors.forename: Bojana
authors.initials: B
authors.lastname: Stamenkovic
authors.forename: Dragomir
authors.initials: D
authors.lastname: Marisavljevic
mesh_terms: D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications* / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000209:etiology* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000097:blood / Q000209:etiology* / Q000276:immunology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D055771:Serbia
chemical_list: D017152:Antibodies, Antiphospholipid; D015415:Biomarkers