title: Relation of antiphospholipid antibodies to postmortem brain infarcts in older people.
abstract: BACKGROUND
  There are few data on the relationship of antiphospholipid antibodies (aPLs) to pathologically proven brain infarcts. We tested the hypothesis that aPLs are associated with a higher odds of brain infarcts among older, community-dwelling individuals who came to autopsy.
  
  
  RESULTS
  Specimens and clinical and pathological data were derived from 607 deceased subjects (mean age at death, 89 years; 66% women) who were participating in 1 of 2 cohort studies of aging (Rush Memory and Aging Project and Religious Orders Study) and had agreed to brain autopsy. Brain infarcts were identified on gross and microscopic examinations, and severity of cerebral vessel disease (atherosclerosis, arteriolosclerosis) was graded. Four clinically used aPLs were measured longitudinally: 3 in serum (anticardiolipin antibodies, β2-glycoprotein I, and anti-phosphatidyl-serine) and 1 in plasma (lupus anticoagulant). A quarter of subjects (142 of 607, 23%) had at least 1 aPL present at baseline (median time interval from baseline to death, 4.6 years), and three quarters of these subjects had persistently positive measures over time. In a logistic regression analysis, baseline aPL positivity did not increase the odds of brain infarcts (odds ratio=1.08; 95% confidence interval, 0.74-1.58; P=0.19) or of gross or microscopic infarcts separately. Findings were essentially unchanged when considering number of baseline aPLs, aPLs proximate to death, and persistence of aPLs. Associations did not differ among subjects with increased severity of vessel disease.
  
  
  CONCLUSIONS
  Overall, we did not find evidence that aPLs increase the odds of pathological brain infarcts in older people.
authors.affiliation: From the Rush Alzheimer's Disease Center (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), Department of Neurological Sciences (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio (R.L.B.); Department of Pathology, Montefiore Medical Center, Bronx, NY (J.H.R.); and Departments of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.). zarvanit@rush.edu.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Arvanitakis
authors.affiliation: From the Rush Alzheimer's Disease Center (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), Department of Neurological Sciences (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio (R.L.B.); Department of Pathology, Montefiore Medical Center, Bronx, NY (J.H.R.); and Departments of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors.forename: Robin L
authors.initials: RL
authors.lastname: Brey
authors.affiliation: From the Rush Alzheimer's Disease Center (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), Department of Neurological Sciences (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio (R.L.B.); Department of Pathology, Montefiore Medical Center, Bronx, NY (J.H.R.); and Departments of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors.forename: Jacob H
authors.initials: JH
authors.lastname: Rand
authors.affiliation: From the Rush Alzheimer's Disease Center (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), Department of Neurological Sciences (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio (R.L.B.); Department of Pathology, Montefiore Medical Center, Bronx, NY (J.H.R.); and Departments of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors.forename: Julie A
authors.initials: JA
authors.lastname: Schneider
authors.affiliation: From the Rush Alzheimer's Disease Center (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), Department of Neurological Sciences (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio (R.L.B.); Department of Pathology, Montefiore Medical Center, Bronx, NY (J.H.R.); and Departments of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors.forename: Ana W
authors.initials: AW
authors.lastname: Capuano
authors.affiliation: From the Rush Alzheimer's Disease Center (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), Department of Neurological Sciences (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio (R.L.B.); Department of Pathology, Montefiore Medical Center, Bronx, NY (J.H.R.); and Departments of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors.forename: Lei
authors.initials: L
authors.lastname: Yu
authors.affiliation: From the Rush Alzheimer's Disease Center (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), Department of Neurological Sciences (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio (R.L.B.); Department of Pathology, Montefiore Medical Center, Bronx, NY (J.H.R.); and Departments of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors.forename: Sue E
authors.initials: SE
authors.lastname: Leurgans
authors.affiliation: From the Rush Alzheimer's Disease Center (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), Department of Neurological Sciences (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio (R.L.B.); Department of Pathology, Montefiore Medical Center, Bronx, NY (J.H.R.); and Departments of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
authors.affiliation: From the Rush Alzheimer's Disease Center (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), Department of Neurological Sciences (Z.A., J.A.S., A.W.C., L.Y., S.E.L., D.A.B.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio (R.L.B.); Department of Pathology, Montefiore Medical Center, Bronx, NY (J.H.R.); and Departments of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors.forename: Steven R
authors.initials: SR
authors.lastname: Levine
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D001324:Autoantigens / Q000276:immunology; D001344:Autopsy; D001921:Brain / Q000473:pathology; D020520:Brain Infarction / Q000276:immunology* / Q000473:pathology; D002536:Cerebral Arteries / Q000473:pathology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000453:epidemiology; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008297:Male; D010718:Phosphatidylserines / Q000276:immunology; D011446:Prospective Studies; D016037:Single-Blind Method; D053482:beta 2-Glycoprotein I / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid; D001324:Autoantigens; D016682:Lupus Coagulation Inhibitor; D010718:Phosphatidylserines; D053482:beta 2-Glycoprotein I
keywords: antibodies; brain; epidemiology; infarction; risk factors