Prevalence and Risk Factors of Acute Ischemic Stroke in Patients with Antiphospholipid Syndrome: A Retrospective Monocenter Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patient Population
2.2. Detection of aPLs and aGAPSS Calculation
2.3. Statistical Analysis
3. Results
3.1. Clinical and Laboratory Characteristics of APS Patients with Stroke
3.2. Univariate Analysis
3.3. Multivariate Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
aGAPSS | Adjusted global antiphospholipid syndrome |
aGAPSS-IS | aGAPSS–ischemic stroke |
aβ2GPI | Anti-b2 glycoprotein-I antibody |
aCL | Anticardiolipin antibody |
ANA | Antinuclear antibodies |
aPL | Antiphospholipid antibodies |
APS | Antiphospholipid syndrome |
AVN | Avascular necrosis |
CT | Computed tomography |
CI | Confidence interval |
DOAC | Direct oral anticoagulant |
FII | Factor II |
FV | Factor V |
HCQ | Hydroxychloroquine |
IQR | Interquartile ratio |
LA | Lupus anticoagulant |
MRI | Magnetic resonance imaging |
MTHFR | Methylenetetrahydrofolate reductase |
OR | Odds ratio |
SD | Standard deviation |
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APS Patients with Stroke (N = 28) | APS Patients Without Stroke (N = 87) | p | |
---|---|---|---|
Gender, n (%) Male Female | 13 (46.4) 15 (53.6) | 29 (33.3) 58 (66.7) | 0.211 |
Mean age at diagnosis (±SD) | 54 (12.5) | 41.5 (14.3) | <0.001 |
Median age (IQR) | 54 (45–64) | 40 (30–53) | NS |
Previous history of thrombosis, n (%) | 4 (14.28) | 15 (17.3) | 1.000 |
Avascular necrosis, n (%) | 3 (10.7) | 1 (1.2) | 0.043 |
Livedo reticularis, n (%) | 3 (10.7) | 1 (1.2) | 0.043 |
Thrombocytopenia, n (%) | 1 (3.6) | 8 (9.1) | 0.685 |
Neuropsychiatric manifestations, n (%) | 2 (7.2) | 1 (1.2) | 0.144 |
Arterial hypertension, n (%) | 15 (53.6) | 6 (6.9) | <0.001 |
Dyslipidemia, n (%) | 7 (25) | 6 (6.9) | 0.008 |
Diabetes mellitus, n (%) | 1 (3.6) | 3 (3.5) | 1.000 |
Secondary APS, n (%) | 3 (10.7) | 8 (9.2) | 0.725 |
Hyperhomocysteinemia, n (%) | 5 (17.9) | 9 (10.4) | 0.280 |
FV Leiden mutation, n (%) | 3 (10.7) | 7 (8) | 0.6971 |
FII (G20210A) mutation, n (%) | 1 (3.6) | 4 (4.6) | 1.000 |
MTHFR (C677T) mutation, n (%) | 5 (17.9) | 14 (16.1) | 0.827 |
LA positivity, n (%) | 28 (100) | 81 (93.1) | 0.124 |
aCL positivity, n (%) | 12 (42.9) | 26 (29.9) | 0.191 |
aβ2GPI positivity, n (%) | 13 (46.4) | 27 (31) | 0.127 |
Single aPL positivity, n (%) | 15 (53.6) | 61 (70.1) | 0.127 |
Double aPL positivity, n (%) | 5 (17.9) | 13 (15) | |
Triple aPL positivity, n (%) | 8 (28.6) | 13 (14.9) | 0.099 |
ANA positivity, n (%) | 11 (39.3) | 35 (40.2) | 0.507 |
Median aGAPSS (IQR) | 9 (4–13.75) | 8 (4–9) | 0.048 |
Mean C3 levels (mg/dL) (+SD) | 115.1 (±47.8) | 115.9 (±30.4) | 0.953 |
Median C4 levels (mg/dL) (IQR) | 23.3 (16.3–27.1) | 21.8 (16.4–28.5) | 1.000 |
OR | 95% CI | p | |
---|---|---|---|
Age at diagnosis | 0.938 | −0.520, −0.191 | <0.001 |
Livedo reticularis | 10.44 | 0.044, 0.391 | 0.046 |
Avascular necrosis | 10.44 | 0.044, 0.391 | 0.046 |
Arterial hypertension | 15.769 | 0.373, 0.641 | <0.001 |
Dyslipidemia | 4.556 | 0.067, 0.410 | 0.013 |
aCL IgG title | 0.975 | −0.031, −0.033 | 0.035 |
aGAPSS | 0.916 | −0.360, −0.003 | 0.047 |
Hosmer–Lemeshow Test: p = 0.308, x2 = 9.416 | |||
---|---|---|---|
OR | 95% CI | p | |
Gender | 1.171 | 0.284, 4.836 | 0.827 |
Age at diagnosis | 0.925 | 0.876, 0.977 | 0.006 |
Livedo reticularis | 0.017 | 0.000, 0.755 | 0.035 |
Avascular necrosis | 228.573 | 4.684, 11,153.959 | 0.006 |
Arterial hypertension | 608.982 | 20.519, 18,073.990 | <0.001 |
Dyslipidemia | 1.062 | 0.182, 6.203 | 0.947 |
aCL IgG title | 0.916 | 0.863, 0.973 | 0.004 |
aGAPSS | 1.899 | 1.263, 2.854 | 0.002 |
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Evangelidis, P.; Kotsiou, N.; Kalmoukos, P.; Ntova, Z.; Papadopoulou, T.; Chissan, S.; Sarvani, A.; Kokoris, S.; Grouzi, E.; Doumas, M.; et al. Prevalence and Risk Factors of Acute Ischemic Stroke in Patients with Antiphospholipid Syndrome: A Retrospective Monocenter Analysis. J. Cardiovasc. Dev. Dis. 2025, 12, 183. https://doi.org/10.3390/jcdd12050183
Evangelidis P, Kotsiou N, Kalmoukos P, Ntova Z, Papadopoulou T, Chissan S, Sarvani A, Kokoris S, Grouzi E, Doumas M, et al. Prevalence and Risk Factors of Acute Ischemic Stroke in Patients with Antiphospholipid Syndrome: A Retrospective Monocenter Analysis. Journal of Cardiovascular Development and Disease. 2025; 12(5):183. https://doi.org/10.3390/jcdd12050183
Chicago/Turabian StyleEvangelidis, Paschalis, Nikolaos Kotsiou, Panagiotis Kalmoukos, Zacharo Ntova, Theodosia Papadopoulou, Sofia Chissan, Anastasia Sarvani, Styliani Kokoris, Elisavet Grouzi, Michael Doumas, and et al. 2025. "Prevalence and Risk Factors of Acute Ischemic Stroke in Patients with Antiphospholipid Syndrome: A Retrospective Monocenter Analysis" Journal of Cardiovascular Development and Disease 12, no. 5: 183. https://doi.org/10.3390/jcdd12050183
APA StyleEvangelidis, P., Kotsiou, N., Kalmoukos, P., Ntova, Z., Papadopoulou, T., Chissan, S., Sarvani, A., Kokoris, S., Grouzi, E., Doumas, M., Vakalopoulou, S., & Gavriilaki, E. (2025). Prevalence and Risk Factors of Acute Ischemic Stroke in Patients with Antiphospholipid Syndrome: A Retrospective Monocenter Analysis. Journal of Cardiovascular Development and Disease, 12(5), 183. https://doi.org/10.3390/jcdd12050183