Anticardiolipin antibodies and risk of thromboembolic disease in young Jamaican women

Abstract

Background Anticardiolipin antibodies (aCL) are a heterogeneous group of antiphospholipid antibodies that are associated with arterial and venous thrombosis. We measured aCL in women, aged 15-49 years, to determine if they are an independent risk factor for thromboembolic disease. Study Design Case-control study Methods Fifty cases were studied including venous thromboembolism (n=29), stroke and myocardial infarction (n=21), along with 148 age-matched controls. Serum samples were assayed for aCL and anti-ßT>2 glycoprotein 1 antibodies using the enzyme-linked immunosorbent assay (ELISA). Information on other risk factors was obtained by a standardized questionnaire. Results aCL were present in 16/50 (32%) of cases compared with 25/148 (17%) of controls (P=0.02). Unadjusted odds ratio (OR) and 95% confidence interval (95% CI) for thromboembolic disease associated with aCL was 2.32 (1.10-4.87). Other risk factors were hypertension, 2.93 (1.20-7.17) and a history of other heart diseases, 12.78 (1.32-123.60). Adjustment for hypertension, diabetes, oral contraceptive use, smoking, alcohol use, varicose veins, a family history of cardiovascular disease and a history of other heart diseases yielded OR (95% CI) 2.99 (1.32-6.80). ß>2 glycoprotein 1-dependent aCL were also an independent risk factor, OR 4.56 (1.76-17.83). Subgroup analysis was carried out separately for cases of MI and stroke and for venous thrombosis. Adjusted OR (95% CI) associated with aCL in cases of MI and stroke was 1.76 (0.46-6.73) and 3.32 (1.15-9.54) for venous thromboembolism. Conclusion aCL are a risk factor for thromboembolic disease in young Jamaican women. They confer a strong independent risk for venous thromboembolism. © 2001, European Society of Cardiology. All rights reserved.