RECURRENT STROKE AND THROMBO-OCCLUSIVE EVENTS IN THE ANTIPHOSPHOLIPIDSYNDROME

We prospectively studied 81 consecutively identified patients with ant iphospholipid antibodies (aPLs) who developed focal cerebral ischemia over a 7-year period. The mean age of this cohort was approximately a decade younger than the average atherothromboembolic stroke victim and women were more commonly involved than men. The frequency of conventi onal stroke risk factors was lowest in the group of stroke patients wi th the highest levels of IgG cardiolipin immunoreactivity. Other serol ogical abnormalities associated with aPL (false-positive Veneral Disea se Research Laboratory test, thrombocytopenia, prolonged activated par tial thromboplastin time [aPTT]) were more common in the group with ov er 100 GPL units (high positive). Patients with the highest IgG antica rdiolipin titers had the shortest times to subsequent thrombo-occlusiv e events. The most common recurrent event was cerebral infarction, oft en occurring within the first year of follow-up during a mean prospect ive follow-up of 3 years. Over one-half of the cohort had at least one recurrent thrombo-occlusive event during follow-up. This distinct syn drome of cerebral ischemia should be recognized for its younger age at onset, predominance of women, high risk of recurrent thrombo-occlusiv e events, and the possible use of the IgG anticardiolipin antibody tit er for prognosis.