PDF(Pubmed)
Abstract：
BACKGROUND: Antiphospholipid syndrome (APLS) is an established cause of thrombosis and hypercoagulability. However, the clinical characteristics of those with APLS or patients with positive antiphospholipid antibodies (APLA) in the embolic stroke of undetermined source (ESUS) have not been well studied.
METHODS: A retrospective analysis was conducted between January 1, 2010, and December 31, 2020, across all three Mayo Clinic sites. Patients who were included in the study were tested for APLA and had a diagnosis of ESUS. Baseline characteristics, radiographic parameters, and outcome data were collected and compared between those who tested positive for APLS or had positive APLA and those who were negative.
RESULTS: A total of 206 patients were included in the study. Eight (4%) patients were diagnosed with APLS, and 21 (10%) patients had positive APLA. On comparing those with a diagnosis of APLS and those without, patients with APLS were found to be significantly older (75 years old ± 9 vs. 58 years old ± 14, p = 0.001) and were more likely to have a history of cancer (50% vs. 13%, p = 0.012). Those with positive APLA had similar findings of being older (67 years old ±13 vs. 58 years old ± 14 p = 0.003) and more likely to have a history of cancer (29% vs. 8.4% p = 0.027). Radiographically, those with APLS had a higher white matter disease burden (Fazekas score median 2 (IQR 1.5-3) vs. median 1 (IQR 1-2), p = 0.028).
CONCLUSIONS: Both APLS and positive APLA are associated with older age and a history of malignancy. These findings highlight the importance of considering a hypercoagulable evaluation even in the elderly ESUS population.
METHODS: A retrospective analysis was conducted between January 1, 2010, and December 31, 2020, across all three Mayo Clinic sites. Patients who were included in the study were tested for APLA and had a diagnosis of ESUS. Baseline characteristics, radiographic parameters, and outcome data were collected and compared between those who tested positive for APLS or had positive APLA and those who were negative.
RESULTS: A total of 206 patients were included in the study. Eight (4%) patients were diagnosed with APLS, and 21 (10%) patients had positive APLA. On comparing those with a diagnosis of APLS and those without, patients with APLS were found to be significantly older (75 years old ± 9 vs. 58 years old ± 14, p = 0.001) and were more likely to have a history of cancer (50% vs. 13%, p = 0.012). Those with positive APLA had similar findings of being older (67 years old ±13 vs. 58 years old ± 14 p = 0.003) and more likely to have a history of cancer (29% vs. 8.4% p = 0.027). Radiographically, those with APLS had a higher white matter disease burden (Fazekas score median 2 (IQR 1.5-3) vs. median 1 (IQR 1-2), p = 0.028).
CONCLUSIONS: Both APLS and positive APLA are associated with older age and a history of malignancy. These findings highlight the importance of considering a hypercoagulable evaluation even in the elderly ESUS population.
摘要：
背景：抗磷脂综合征（APLS）是血栓形成和高凝状态的确定原因。然而,在来源不明的栓塞性卒中(ESUS)中,APLS患者或抗磷脂抗体(APLA)阳性患者的临床特征尚未得到充分研究.
方法：在2010年1月1日至2020年12月31日期间，对所有三个梅奥诊所进行了回顾性分析。纳入研究的患者接受了APLA测试，并诊断为ESUS。基线特征，射线照相参数，收集结果数据,并比较APLS检测阳性或APLA检测阳性的患者和APLA检测阴性的患者.
结果：共206例患者纳入研究。8例（4%）患者被诊断为APLS，21例(10%)患者APLA阳性。在比较诊断为APLS的患者和没有APLS的患者时，发现APLS患者年龄明显较大（75岁±9岁与58岁±14岁，p=0.001），更可能有癌症史（50％vs.13%,p=0.012)。APLA阳性的人在年龄较大时也有类似的发现（67岁±13岁与58岁±14p=0.003），更可能有癌症史（29%vs.8.4%p=0.027)。射线照相,APLS患者的白质疾病负担较高（Fazekas评分中位数2（IQR1.5-3）与中位数1（IQR1-2），p=0.028)。
结论：APLS和阳性APLA均与年龄较大和恶性肿瘤病史相关。这些发现强调了即使在老年ESUS人群中考虑高凝评估的重要性。
方法：在2010年1月1日至2020年12月31日期间，对所有三个梅奥诊所进行了回顾性分析。纳入研究的患者接受了APLA测试，并诊断为ESUS。基线特征，射线照相参数，收集结果数据,并比较APLS检测阳性或APLA检测阳性的患者和APLA检测阴性的患者.
结果：共206例患者纳入研究。8例（4%）患者被诊断为APLS，21例(10%)患者APLA阳性。在比较诊断为APLS的患者和没有APLS的患者时，发现APLS患者年龄明显较大（75岁±9岁与58岁±14岁，p=0.001），更可能有癌症史（50％vs.13%,p=0.012)。APLA阳性的人在年龄较大时也有类似的发现（67岁±13岁与58岁±14p=0.003），更可能有癌症史（29%vs.8.4%p=0.027)。射线照相,APLS患者的白质疾病负担较高（Fazekas评分中位数2（IQR1.5-3）与中位数1（IQR1-2），p=0.028)。
结论：APLS和阳性APLA均与年龄较大和恶性肿瘤病史相关。这些发现强调了即使在老年ESUS人群中考虑高凝评估的重要性。
