Antiphospholipid-protein antibodies and acute ischemic stroke in the NINDS rt-PA Stroke Trial

Antiphospholipid antibodies (aPL) are a family of autoantibodies that exhibit a broad range of target specificities and affinities, all recognizing various combinations of phospholipids, phospholipid-binding proteins, or both.1 aPL are linked to immune-mediated clotting in both arterial and venous beds, but their clinical role in unselected patients with ischemic stroke is not resolved.2-5⇓⇓⇓ We report a study of patients from the National Institute of Neurologic Diseases and Stroke (NINDS) Recombinant Tissue Plasminogen Activator (rt-PA) Stroke Trial6 that was designed to investigate the relationship of a battery of aPL to outcome in the acute phase of ischemic stroke, response to IV rt-PA, and risk of rt-PA–related intracerebral hemorrhage (ICH). The NINDS rt-PA Stroke Trial consisted of two sequential placebo-controlled, randomized, double-blind, multicenter clinical trials.6 Blood samples obtained from patients within the first 24 hours were collected in citrated tubes, frozen, and stored at −70 °C. Available ELISA kits were used to determine a battery of aPL that included the following: anticardiolipin antibodies (aCL; …

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