Current status and role of antiphospholipid antibody testing in cryptogenic stroke.

BACKGROUND Although it is not recognized as essential to check antiphospholipid antibody (aPL) in stroke of unknown cause, aPL-related stroke may account for appreciable cases of cryptogenic strokes. We aimed to assess the current status and diagnostic value of aPL testing in cryptogenic stroke patients. METHODS Consecutive patients admitted with acute ischemic stroke were examined to confirm the factors associated with performing aPL test and positive aPL test results in real-world practice. Cryptogenic stroke patients were separately examined in the same manner. Antibody profiles of cryptogenic stroke patients with positive aPL were compared by age. RESULTS Among 2,947 patients, 606 (20.6%) were tested for aPL and 129 (21.3%) were positive. Physicians tended to perform aPL testing in patients aged 40% (<50 years, 43.2%; ≥50 years, 40.4%; p=0.92) and their antibody profiles were similar. CONCLUSIONS A significant number of patients with cryptogenic stroke had positive aPL results regardless of age. aPL testing may offer additional diagnostic opportunities to cryptogenic stroke patients, and thus may reduce the incidence of cryptogenic stroke.