Abstract 4361466: Association Between Antiphospholipid Antibody and Ischemic Stroke: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Emerging evidence suggests that antiphospholipid antibodies (aPL) may be associated with an increased cardiovascular risk beyond the thrombotic antiphospholipid syndrome (APS). Among patients with ischemic stroke, the clinical significance of single positive aPL remains ill-defined. We aimed to assess the prevalence of aPL seropositivity in patients with stroke and the association between aPL seropositivity and stroke risk. Methods: This analysis is part of a larger project with PROSPERO ID CRD420251047305. We conducted a systematic search of PubMed and Embase on 5/13/2025 to identify cohort or case-control studies of unselected adult patients (without APS) investigating the association between aPL seropositivity and acute ischemic stroke compared with non-stroke controls. Positivity for aPL was defined as a single positive measurement for lupus anticoagulant in clot-based assays, IgM/IgG anti-β2-glycoprotein I antibody, or IgM/IgG anticardiolipin antibody at the time of stroke. Random-effects models with inverse weights were utilized to calculate pooled odds ratios (OR) with 95% confidence intervals (CIs). Results: Among 3,241 unique records, 43 studies (39 case-control and 4 cohort studies) were included representing a total of 6,374 patients (mean age 59.0 years, 51.1% men). The pooled prevalence of aPL seropositivity among patients with ischemic stroke was 18.1% (95% CI 17.2%-19.0%) (Figure, Panel A). Patients with ischemic stroke, compared with non-stroke controls, had a higher odds for seropositivity for aPL (OR: 2.94, 95% CI 2.31-3.74, I 2 =69%) (Figure, Panel B). In sensitivity analysis following removal of outlier studies, similar findings were demonstrated with overall improvement in model heterogeneity (OR: 2.58, 95% CI, 2.21-3.02, I 2 =20%). Conclusion: In this analysis, seropositivity for aPL were present in nearly one in five patients with ischemic stroke, significantly more than in the general population, and were associated with an increased odds of stroke. Whether seropositivity for aPL at a single time point is a causal risk factor for stroke warrants further investigation in future prospective studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.022 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.026 |
| Bibliometrics | 0.006 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".