PREVALENCE AND CLINICAL-SIGNIFICANCE OF ANTIPHOSPHOLIPID ANTIBODIES IN HEART-VALVE DISEASE - A CASE-CONTROL STUDY

The purposes of this study were (1) to assess the prevalence of antiph ospholipid (aPL) antibodies in patients with nonspecific heart valve d isease referred for valve replacement and (2) to determine whether the presence of aPL antibodies carries a risk for thrombotic events durin g a postoperative follow-up in a prospective cohort. The sera of 89 co nsecutive patients and 80 matched control subjects were tested for ant ibodies to cardiolipin (immunoglobulin G and immunoglobulin M) and for lupus anticoagulant. The prevalence of aPL antibodies was significant ly higher in patients (19 [21%] of 89) than in control subjects (7 [9% ] of 80) (p < 0.05). Patients were divided into two subgroups accordin g to the presence (subgroup A) or the absence (subgroup a) of aPL anti bodies. No significant difference in age or sex ratio was observed bet ween the two subgroups. A history of arterial thrombosis was more freq uent in subgroup A (8 [42%] of 19) than in subgroup a (8 [11%] of 70) (p < 0.01). No significant difference with respect to the; occurrence of thrombotic events was observed during a median follow-up period of 8.7 months. Thus a high prevalence of aPL antibodies was found in pati ents referred for heart valve replacement compared with matched contro l subjects. No increased risk has been demonstrated in the patients wi th aPL antibodies.