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June 9, 2004

Antiphospholipid Antibodies and Risk for Recurrent Vascular Events

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(22):2701. doi:10.1001/jama.291.22.2701-c

To the Editor: Dr Levine and colleagues1 reported that the presence of either LA or aCL did not predict risk for further thrombo-occlusive events among patients with stroke. The authors defined aPL positivity as the presence of LA, aCL, or both. Diagnosis of APS, however, requires aPL positivity to persist over time.2 But because the authors only measured this once, some of these results might be false positives or transient increases. We are also concerned that the majority of patients with positive aCL test results had low levels, a finding which is of dubious clinical significance. The relevance of IgA aCL determination is still questionable in any event. Furthermore, the age of the population should be taken into account, as the prevalence of background aCL positivity increases with age.3

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