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To Editor: Dr Levine and colleagues¹ found that the presence of antiphospholipid antibodies (aPL) among patients with ischemic stroke did not predict an increased risk for subsequent vascular occlusive events. Thus, the authors concluded that routine screening for aPL did not appear warranted for secondary prevention of stroke. These results appear discordant, however, with a previous study by the same authors, which found that presence of anticardiolipin antibodies (aCL) was associated with a higher risk of stroke.²

For several reasons, I doubt that the authors' current results are necessarily applicable to all populations of patients with stroke. First, the mean age of patients in this study was 62.5, similar to that in the authors' prior study.² This differs substantially from the mean age of 34 years at disease onset in 1000 patients with primary or secondary antiphospholipid syndrome (APS),³ of whom 131 (13.1%) had had a stroke at disease onset, . . . [Full Text of this Article]

Antonio R. Cabral, MD
acabral@quetzal.innsz.mx
Department of Immunology and Rheumatology
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Mexico City, Mexico

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