title: Antiphospholipid antibodies correlate with stroke severity and outcome in patients with antiphospholipid syndrome.
abstract: BACKGROUND
  Our goal was to analyze the association of the level of antiphospholipid antibodies (aPLs) with stroke severity and outcome in patients with antiphospholipid syndrome (APS).
  
  
  METHODS
  Observational study included consecutive patients with ischemic stroke younger than 55 years (2007-2012). We analyzed serum levels of aPLs, including anticardiolipin (aCL) antibodies, anti-β2-glycoprotein I antibodies (anti-β2GPI) and antiprothrombin antibodies (aPS/PT) within the first 48 h after admission, and again, in the case of a positive result, at least 12 weeks after the first measurement. Stroke severity was measured by the National Institutes of Health Stroke Scale (NIHSS), and the three-month stroke outcome by the modified Rankin Scale (mRS). Multiple linear regression models were used to analyze the correlation between the aPLs and stroke severity and outcome.
  
  
  RESULTS
  Overall 255 stroke patients were included, 22 (8.6%) with APS. Among them, a positive correlation was found between immunoglobulin M (IgM) aCL levels within 48 h and NIHSS (rho = 0.471; p = 0.027), as well as a tendency toward a positive correlation between immunoglobulin G (IgG) anti-β2GPI levels within 48 h and three-month mRS (rho = 0.364; p = 0.096). Multiple linear regression analyses showed a positive correlation between levels of IgM aCL < 48 h and the NIHSS (β-coefficient [standard error; SE] = 0.127 [0.044]), as well as the levels of IgG anti-β2GPIwithin 48 h and the three-month mRS (β-coefficient [SE] = 0.034 [0.011]).
  
  
  CONCLUSIONS
  In young stroke patients with APS, serum levels of IgM aCL within 48 h are correlated with stroke severity and levels of IgG anti-β2GPI within 48 h are correlated with three-month outcomes.
authors.affiliation: Department of Neurology and Stroke Center .
authors.forename: Ana
authors.initials: A
authors.lastname: Rodríguez-Sanz
authors.forename: Patricia
authors.initials: P
authors.lastname: Martínez-Sánchez
authors.forename: Daniel
authors.initials: D
authors.lastname: Prefasi
authors.forename: Blanca
authors.initials: B
authors.lastname: Fuentes
authors.forename: Dora
authors.initials: D
authors.lastname: Pascual-Salcedo
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Blanco-Bañares
authors.forename: Exuperio
authors.initials: E
authors.lastname: Díez-Tejedor
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011379:Prognosis; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*
chemical_list: D017152:Antibodies, Antiphospholipid; D001323:Autoantibodies
keywords: Anticardiolipin antibodies; anti-β2-Glycoprotein I; antiphospholipid antibodies; antiphospholipid syndrome; brain infarction; stroke