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Relation of Antiphospholipid Antibodies to Postmortem Brain Infarcts in Older Persons.
MedLine Citation:
PMID:  25301832     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -There are little data on the relationship of antiphospholipid antibodies (aPL) to pathologically-proven brain infarcts. We tested the hypothesis that aPL are associated with a higher odds of brain infarcts among older, community-dwelling persons who came to autopsy.
METHODS AND RESULTS: -Specimens, and clinical and pathologic data, were derived from 607 deceased subjects (mean age-at-death = 89 years, 66% women) who were participating in one of two cohort studies of aging (Rush Memory and Aging Project; Religious Orders Study) and had agreed to brain autopsy. Brain infarcts were identified on gross and microscopic examinations, and severity of cerebral vessel disease (atherosclerosis, arteriolosclerosis) was graded. Four clinically-used aPL were measured longitudinally: three in serum (anticardiolipin antibodies, β2-glycoprotein I, and antiphosphatidyl-serine), and one in plasma (lupus anticoagulant). A quarter of subjects (142/607, 23%) had at least one aPL present at baseline (median time interval from baseline to death =4.6 years), and three-quarters of these had persistently positive measures over time. In a logistic regression analysis, baseline aPL positivity did not increase the odds of brain infarcts (OR =1.08; 95% CI: 0.74, 1.58; p=0.19), or of gross or microscopic infarcts separately. Findings were essentially unchanged when considering number of baseline aPL, aPL proximate to death, and persistence of aPL. Associations did not differ among subjects with increased severity of vessel disease.
CONCLUSIONS: -Overall, we did not find evidence that aPL increase the odds of pathological brain infarcts in older persons.
Authors:
Zoe Arvanitakis; Robin L Brey; Jacob H Rand; Julie A Schneider; Ana W Capuano; Lei Yu; Sue E Leurgans; David A Bennett; Steven R Levine
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-9
Journal Detail:
Title:  Circulation     Volume:  -     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-10     Completed Date:  -     Revised Date:  2014-10-11    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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