Puisieux F, de Groote P, Masy E, Di Pompeo C, Millaire A, Bouillanne O, Jude B, Dewailly P, Ducloux G
Service de Médecine Interne, Centre Hospitalier et Universitaire de Lille, Lille, France.
Am J Med. 2000 Dec 1;109(8):635-41. doi: 10.1016/s0002-9343(00)00600-8.
Anticardiolipin antibodies may be associated with recurrent thromboembolic events in patients with myocardial infarction or stroke. We sought to determine the prevalence of anticardiolipin antibodies in patients with peripheral arterial disease and their association with subsequent thromboembolic events and mortality.
We ascertained anticardiolipin antibodies using a standardized enzyme-linked immunosorbent assay (immunoglobulin G [IgG] anticardiolipin > or =15 GPL units or IgM anticardiolipin > or =15 MPL units) in 232 patients with peripheral arterial disease and 100 control subjects. Patients were observed to determine overall and cardiovascular mortality, and incident thromboembolic events.
IgG anticardiolipin antibodies were significantly more common in the patients with peripheral arterial disease (36 of 232 [16%]) than in the controls (7 of 100 [7%], P = 0.03). During a median follow-up of 3.5 years, 3 of the 232 patients were lost to follow-up and 56 (24%) died. Overall mortality was significantly greater in the IgG anticardiolipin-positive patients (16 of 35 [46%]) compared with those who were IgG anticardiolipin-negative (40 of 194 [21%], P = 0.0003), largely due to an increase in cardiovascular mortality among the IgG anticardiolipin-positive patients. In a multivariate proportional hazards analysis, IgG anticardiolipin antibodies were an independent risk factor for overall mortality (hazard ratio [HR] = 2.1, 95% confidence interval [CI]: 1.2 to 4.0) and cardiovascular mortality (HR = 4.4, 95% CI: 1.6 to 12).
IgG anticardiolipin antibodies are common in patients with peripheral arterial disease and are associated with an increased risk of overall and cardiovascular mortality.
抗心磷脂抗体可能与心肌梗死或中风患者复发性血栓栓塞事件相关。我们试图确定外周动脉疾病患者中抗心磷脂抗体的患病率及其与随后血栓栓塞事件和死亡率的关联。
我们使用标准化酶联免疫吸附试验（免疫球蛋白G [IgG]抗心磷脂≥15 GPL单位或IgM抗心磷脂≥15 MPL单位）在232例外周动脉疾病患者和100例对照者中检测抗心磷脂抗体。观察患者以确定总体和心血管死亡率以及血栓栓塞事件的发生率。
外周动脉疾病患者中IgG抗心磷脂抗体明显比对照组更常见（232例中有36例[16%]），而对照组为100例中有7例[7%]，P = 0.03）。在中位随访3.5年期间，232例患者中有3例失访，56例（24%）死亡。IgG抗心磷脂阳性患者的总体死亡率明显高于IgG抗心磷脂阴性患者（35例中有16例[46%]），而IgG抗心磷脂阴性患者为194例中有40例[21%]，P = 0.0003），这主要是由于IgG抗心磷脂阳性患者中心血管死亡率增加。在多变量比例风险分析中，IgG抗心磷脂抗体是总体死亡率（风险比[HR] = 2.1，95%置信区间[CI]：1.2至4.0）和心血管死亡率（HR = 4.4，95% CI：1.6至12）的独立危险因素。
IgG抗心磷脂抗体在周围动脉疾病患者中很常见，并且与总体和心血管死亡率增加相关。
