Association between anticardiolipin antibodies and mortality in patients with peripheral arterial disease

PURPOSE: Anticardiolipin antibodies may be associated with recurrent thromb oembolic events in patients with myocardial infarction or stroke. We sought to determine the prevalence of anticardiolipin antibodies in patients with peripheral arterial disease and their association with subsequent thromboe mbolic events and mortality. METHODS: We ascertained anticardiolipin antibodies using a standardized enz yme-linked immunosorbent assay (immunoglobulin G [IgG] anticardiolipin grea ter than or equal to 15 GPL units or IgM anticardiolipin greater than or eq ual to 15 MPL units) in 232 patients with peripheral arterial disease and 1 00 control subjects. Patients were observed to determine overall and cardio vascular mortality, and incident thromboembolic events. RESULTS: IgG anticardiolipin antibodies were significantly more common in t he patients with peripheral arterial disease (36 of 232 [16%]) than in the controls (7 of 100 [7%], P = 0.03). During a median follow-up of 3.5 years, 3 of the 232 patients were lost to follow-up and 56 (24%) died. Overall mo rtality nas significantly greater in the IgG anticardiolipin-positive patie nts (16 of 35 [46%]) compared with those who were IgG anticardiolipin-negat ive (40 of 194 [21%], P = 0.0003), largely due to an increase in cardiovasc ular mortality among the IgG anticardiolipin-positive patients. In a multiv ariate proportional hazards analysis, IgG anticardiolipin antibodies were a n independent risk factor for overall mortality (hazard ratio [HR] = 2.1, 9 5% confidence interval [CI]: 1.2 to 4.0) and cardiovascular mortality (HR = 4.4, 95% CI: 1.6 to 12). CONCLUSIONS: IgG anticardiolipin antibodies are common in patients with per ipheral arterial disease and are associated with an increased risk of overa ll and cardiovascular mortality. (C) 2000 by Excerpta Medica, Inc.