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-βT₂ 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). β₂ 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.