Study points to major heart, stroke risk for some women

The probe, appearing in The Lancet Neurology, focuses on the risks for women from antiphospholipid syndrome, raising the question whether there should be screening or awareness programs about the disorder.

Antiphospholipid syndrome occurs when antibodies, the frontline forces of the immune system, adhere to cell membranes, disrupting the blood's regular clotting mechanisms. The disorder has been in the spotlight in the past for causing bleeding, thrombosis and repeated miscarriage.

The Dutch study, published in The Lancet Neurology journal, is the first to look at its impact in terms of stroke and heart attack.

Investigators looked at data from 1,006 women aged 18-49 who took part in a different study, known as RATIO, between 1990 and 2001. The volunteers gave samples of blood for testing for antiphospholipid antibodies known as lupus anticoagulant (LA), and responded to a questionnaire about their lifestyle.

Of the pool, 175 had had a stroke and 203 had had a heart attack; there were 628 otherwise healthy women.

LA was found in 30, or 17 percent, of patients who had suffered a stroke; in six (three percent) of those who had had a heart attack; but in merely four (0.4 percent) of the controls.

Only between 1.2 and 3.8 percent of the public have LA, according to past studies, while the Dutch investigation found a prevalence of only 0.6 percent in its pool.

Despite the low frequency of LA, these so-called auto-antibodies could account for an inordinate number of hospitalizations, especially when vascular risk factors such as smoking and the contraceptive pill are factored in, the authors say.

LA plus smoking increased the risk of heart attacks 34-fold, and LA plus oral contraceptives increased the risk 22-fold, the new investigation found.

The article is headed by Rolf Urbanus and Philip de Groot at the University Medical Centre, Utrecht.

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