Internal Med Medical News

Become a Member Today!
Register

Most Viewed Abstracts

1. Report Shows Shift in Starting Salaries for Physicians

2. Recommendations on the use of 18F-FDG PET in oncology

3. Gene expression signatures, clinicopathological features, and individualized therapy in breast cancer

4. AHA Guidelines on Cardiac CT for Assessing Coronary Artery Disease

5. Rapid correction of low vitamin D status in nursing home residents

Your Article Summary

See Latest Articles

(Click the title below to leave the MDLinx Network and go to the Journal's Website)

Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study
The Lancet Neurology, 10/16/09

Urbanus RT et al. – Arterial thrombosis is a major clinical manifestation of the antiphospholipid syndrome, which is an autoimmune disease found mostly in young women. Although the presence of circulating antiphospholipid antibodies in individuals who have a thrombotic event is a prerequisite for the diagnosis of the antiphospholipid syndrome, the risk of arterial thrombosis associated with antiphospholipid antibodies in the general population is unclear.Our results suggest that lupus anticoagulant is a major risk factor for arterial thrombotic events in young women, and the presence of other cardiovascular risk factors increases the risk even further.

Methods

RATIO (Risk of Arterial Thrombosis In relation to Oral contraceptives), a large multicentre population-based case-control study
Women aged under 50 years who were admitted to hospital at 16 centres with first ischaemic stroke or myocardial infarction between January, 1990, and October enrolled
Additional 59 women who presented with ischaemic stroke at University Medical Centre Utrecht between 1996 and 2001 also enrolled
Information on cardiovascular risk factors (such as oral contraceptive use, smoking, and hypertension) assessed with standard questionnaire
During the second phase (1998—2002), blood samples taken to measure antiphospholipid antibody profiles (lupus anticoagulant, anticardiolipin IgG, anti-?2-glycoprotein I IgG, and antiprothrombin IgG) and determine genetic prothrombotic risk factors (factor V G1691A variant, prothrombin G20210A variant, and factor XIII 204Phe allele)

Results

175 patients with ischaemic stroke, 203 patients with myocardial infarction, and 628 healthy controls included
Lupus anticoagulant found in 30 (17%) patients with ischaemic stroke, 6 (3%) patients with myocardial infarction, and 4 (0·7%) in control group
Odds ratio for MI 5·3 (95% CI 1·4—20·8), which increased to 21·6 (1·9—242·0) in oral contraceptive users and 33·7 (6·0—189·0) in smokers
Odds ratio for ischaemic stroke 43·1 (12·2—152·0), which increased to 201·0 (22·1—1828·0) in oral contraceptive users and 87·0 (14·5—523·0) in smokers
In women who had anti-?2-glycoprotein I antibodies, risk of ischaemic stroke 2·3 (1·4—3·7), but risk of MI not increased (0·9, 0·5—1·6)
Neither anticardiolipin nor antiprothrombin antibodies affected risk of MI or ischaemic stroke