title: Antiphospholipid antibodies and lower extremity peripheral arterial disease - a systematic review and meta-analysis.
abstract: BACKGROUND
  Despite being an important risk factor for venous thromboembolism and ischaemic stroke, the role of antiphospholipid antibodies in patients with peripheral arterial disease remains a matter of debate. The aim of this study was to evaluate the association of persistently elevated antiphospholipid antibodies and lower extremity peripheral arterial disease.
  
  
  METHODS
  We conducted a systematic review of electronic databases including MEDLINE, EUROPUBMED and EMBASE to assess the prevalence of antiphospholipid antibodies in patients with lower extremity peripheral arterial disease. Case-control studies were included if they reported the prevalence of antiphospholipid antibodies in patients with lower extremity peripheral arterial disease. Two reviewers (FV and EG) independently assessed the eligibility of all articles. The primary outcome measure was the odds ratio (OR) for the prevalence of antiphospholipid antibodies patients with lower extremity peripheral arterial disease, along with the corresponding 95 % confidence intervals (CIs).
  
  
  RESULTS
  Our initial electronic search identified 128 relevant abstracts, of which two studies were included. Antiphospholipid antibodies were found in 50/571 patients with lower extremity peripheral arterial disease and 13/490 of the controls, OR 3.32 (95 % CI = 1.49 to 7.4). In those with critical limb ischaemia, the prevalence of antiphospholipid antibodies was elevated compared to controls, pooled OR 4.78 (95 % CI = 2.37 to 9.65).
  
  
  CONCLUSIONS
  Our systematic review and meta-analysis suggests that the prevalence of persistently elevated levels of antiphospholipid antibodies is increased in patients with lower extremity peripheral diseases when compared to healthy controls, especially in those with critical limb ischaemia.
authors.affiliation: 1 University of Ottawa Faculty of Medicine, Ottawa, Canada.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Gavier
authors.affiliation: 1 University of Ottawa Faculty of Medicine, Ottawa, Canada.
authors.forename: Fernando
authors.initials: F
authors.lastname: Vazquez
authors.affiliation: 1 University of Ottawa Faculty of Medicine, Ottawa, Canada.
authors.forename: Esteban
authors.initials: E
authors.lastname: Gandara
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000097:blood*; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D058729:Peripheral Arterial Disease / Q000276:immunology*
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: Peripheral vasculature-thrombin-antiphospholipid antibodies