TY - JOUR
T1 - Anti-beta2-glycoprotein I IgG antibodies are associated with early-onset cryptogenic ischemic stroke
AU - the SECRETO Study Group
AU - Jaakonmäki, Nina
AU - Helin, Tuukka
AU - Szanto, Timea
AU - Zedde, Marialuisa
AU - Sarkanen, Tomi
AU - Martinez-Majander, Nicolas
AU - Sinisalo, Juha
AU - Junttola, Ulla
AU - Redfors, Petra
AU - von Sarnowski, Bettina
AU - Waje-Andreassen, Ulrike
AU - Ylikotila, Pauli
AU - Yesilot, Nilufer
AU - Ryliskiene, Kristina
AU - Tulkki, Lauri
AU - Amaya Pascasio, Laura
AU - Licenik, Radim
AU - Ferdinand, Phillip
AU - Gerdts, Eva
AU - Jatužis, Dalius
AU - Pezzini, Alessandro
AU - Kõrv, Janika
AU - Huhtakangas, Juha
AU - Fonseca, Ana Catarina
AU - Joutsi-Korhonen, Lotta
AU - Cate, Hugoten
AU - Jäkälä, Pekka
AU - Putaala, Jukka
N1 - Publisher Copyright:
© European Stroke Organisation 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
PY - 2025/7/5
Y1 - 2025/7/5
N2 - Background: Previously undetected antiphospholipid antibodies (aPLs) potentially provide explanations for early-onset cryptogenic ischemic stroke (CIS). Prior association studies conducted over a decade ago were inconclusive and not focused on patients with CIS. Methods: SECRETO is a multi-center case-control study enrolling patients aged 18–49 years with imaging-positive acute CIS and 1:1 matched stroke-free controls. Lupus anticoagulant (LA), anticardiolipin (aCL), and anti-beta2-glycoprotein I (aβ2GPI) IgG antibodies were assessed from blood samples taken at two time points (baseline and 12-weeks) from patients and at a single time point from controls. Conditional logistic regression models assessed the association of aPLs, adjusted for age, level of education, and vascular risk factors. Results: A total of 503 patient-control pairs were analyzed. At either time-point, compared to healthy controls, patients had more frequently positive aβ2GPI (patients 11.9% vs controls 2.0%, p < 0.001). There was no significant difference in the presence of positive LA between patients and controls. In the logistic regression model, at either time-point positive aB2GI and aCL were associated with CIS (odds ratio [OR] 11.22, 95% confidence interval [CI] 4.35–28.95 and OR 20.85, 95% CI 204–213.16, respectively). The frequency of patients with positive aβ2GPI or aCL increased from baseline to 12 weeks (p < 0.001), whereas frequency of positive LA results decreased (p < 0.001). Conclusions: Positive aβ2GPI and aCL, but not LA, detected either shortly after stroke or after 12 weeks were associated with early-onset CIS. Notably, after the acute phase, frequencies of positive aβ2GPI and aCL increased, whereas LA showed a reverse trend.
AB - Background: Previously undetected antiphospholipid antibodies (aPLs) potentially provide explanations for early-onset cryptogenic ischemic stroke (CIS). Prior association studies conducted over a decade ago were inconclusive and not focused on patients with CIS. Methods: SECRETO is a multi-center case-control study enrolling patients aged 18–49 years with imaging-positive acute CIS and 1:1 matched stroke-free controls. Lupus anticoagulant (LA), anticardiolipin (aCL), and anti-beta2-glycoprotein I (aβ2GPI) IgG antibodies were assessed from blood samples taken at two time points (baseline and 12-weeks) from patients and at a single time point from controls. Conditional logistic regression models assessed the association of aPLs, adjusted for age, level of education, and vascular risk factors. Results: A total of 503 patient-control pairs were analyzed. At either time-point, compared to healthy controls, patients had more frequently positive aβ2GPI (patients 11.9% vs controls 2.0%, p < 0.001). There was no significant difference in the presence of positive LA between patients and controls. In the logistic regression model, at either time-point positive aB2GI and aCL were associated with CIS (odds ratio [OR] 11.22, 95% confidence interval [CI] 4.35–28.95 and OR 20.85, 95% CI 204–213.16, respectively). The frequency of patients with positive aβ2GPI or aCL increased from baseline to 12 weeks (p < 0.001), whereas frequency of positive LA results decreased (p < 0.001). Conclusions: Positive aβ2GPI and aCL, but not LA, detected either shortly after stroke or after 12 weeks were associated with early-onset CIS. Notably, after the acute phase, frequencies of positive aβ2GPI and aCL increased, whereas LA showed a reverse trend.
KW - Antiphospholipid antibodies
KW - ischemic stroke
KW - young adult
U2 - 10.1177/23969873251351207
DO - 10.1177/23969873251351207
M3 - Article
C2 - 40616446
AN - SCOPUS:105013250356
SN - 2396-9873
JO - European Stroke Journal
JF - European Stroke Journal
M1 - 23969873251351207
ER -