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Yang W, Kang MK, Ha SY, et al. Current status and role of antiphospholipid antibody testing in cryptogenic stroke. Eur J Neurol. 2021;doi: 10.1111/ene.15191.
Yang, W., Kang, M. K., Ha, S. Y., Kang, D. W., Bae, J., Lee, E. J., Jeong, H. Y., Kim, J. M., Jung, K. H., & Lee, S. H. (2021). Current status and role of antiphospholipid antibody testing in cryptogenic stroke. European journal of neurology, . https://doi.org/10.1111/ene.15191
Yang, Wookjin, et al. "Current status and role of antiphospholipid antibody testing in cryptogenic stroke." European journal of neurology vol. (2021). doi: https://doi.org/10.1111/ene.15191
Yang W, Kang MK, Ha SY, Kang DW, Bae J, Lee EJ, Jeong HY, Kim JM, Jung KH, Lee SH. Current status and role of antiphospholipid antibody testing in cryptogenic stroke. Eur J Neurol. 2021 Nov 20; doi: 10.1111/ene.15191. Epub 2021 Nov 20. PMID: 34800314.
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Eur J Neurol. 2021 Nov 20; doi: 10.1111/ene.15191. Epub 2021 Nov 20.

Current status and role of antiphospholipid antibody testing in cryptogenic stroke.

European journal of neurology

Wookjin Yang, Min Kyoung Kang, Sue Young Ha, Dong-Wan Kang, Jeonghoon Bae, Eung-Joon Lee, Han-Yeong Jeong, Jeong-Min Kim, Keun-Hwa Jung, Seung-Hoon Lee

Affiliations

  1. Department of Neurology, Seoul National University Hospital, Seoul, Korea.
  2. Korean Cerebrovascular Research Institute, Seoul, Korea.
  3. Department of Neurology, Uijeongbu Eulji Medical Center, Uijeongbu-si, Korea.
  4. Cenyx Biotech Inc., Seoul, Korea.

PMID: 34800314 DOI: 10.1111/ene.15191

Abstract

BACKGROUND AND PURPOSE: Although it is not recognized as essential to test for antiphospholipid antibody (aPL) in stroke of unknown cause, aPL-related stroke may account for a considerable number of cryptogenic strokes. We aimed to assess the current status and diagnostic value of aPL testing in cryptogenic stroke patients.

METHODS: Consecutive patients admitted with acute ischemic stroke were examined to confirm the factors associated with performing aPL testing and with positive aPL test results in real-world practice. Cryptogenic stroke patients were separately examined in the same manner. The antibody profiles of cryptogenic stroke patients with aPL positivity were compared by age.

RESULTS: Among 2947 patients, 606 (20.6%) were tested for aPLs and 129 (21.3%) were positive. Physicians tended to perform aPL testing in patients aged <50 years and in cryptogenic stroke patients. Cryptogenic stroke was a strong predictor of positive aPL results (adjusted odds ratio 3.70, 95% confidence interval 2.38-5.76). However, aPL positivity did not differ by age in stroke patients. Among 283 cryptogenic stroke patients, 136 (48.1%) were tested for aPLs and 56 (41.2%) were positive. aPL tests were performed predominantly in patients aged <50 years rather than in older patients, even among cryptogenic stroke patients. The two age groups had similar positivity rates of >40% (<50 years: 43.2%; ≥50 years: 40.4%; p = 0.92) and their antibody profiles were similar.

CONCLUSIONS: A significant number of patients with cryptogenic stroke had positive aPL results regardless of age. aPL testing may offer additional diagnostic opportunities in cryptogenic stroke patients, and thus may reduce the incidence of cryptogenic stroke.

© 2021 European Academy of Neurology.

Keywords: Antibodies, Antiphospholipid; antiphospholipid syndrome; cryptogenic stroke; ischemic stroke; stroke

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