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The importance of a prothrombotic state as a cause of ischemic stroke in young adults is ill defined.We examined 46 unselected patients under age 50 years with cerebral ischemia for anticardiolipin antibody(aCL)and lupus anticoagulants(LA),over a 3-year period.Age-and sex-matched patients with other neurologic diseases served as a noncerebral ischemia comparison group to test whether(1)stroke/transient ischemic attacks(TIA)in young people is associated with aCL and/or LA,and(2)their presence is specific to cerebral ischemia.In the stroke/TIA group,21 patients had aCL or LA and 25 had neither,whereas in the control group,2 patients had aCL and 24 had neither.Equal numbers of stroke/TIA patients with and without antiphospholipid antibodies(aPL)had other stroke risk factors.Patients with aPL and cerebral ischemia,however,had a more frequent history of multiple events than those without them.These antibodies occur with undue frequency in young patients with stroke/TIA and are not associated with a concurrent diagnosis of systemic lupus in most cases.A coexistent aPL associated prothrombotic state may be a key determinant of whether patients with atherosclerosis,mitral valve prolapse,or other structural lesions experience recurrent ischemia. |
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