Radin M, et al. - Predictive factors of ischaemic stroke were identified in a cohort of primary APS (PAPS) patients who presented with new onset symptoms suggestive of acute stroke. Despite anticoagulation treatment, patients with PAPS had a high risk of recurrent thrombosis, including young patients. To identify patients at risk for recurrence, a careful risk assessment was mandatory.

• The clinicians enrolled 36 consecutive PAPS patients who presented with new onset symptoms suggestive of an acute stroke in this prospective multicenter study.
• They prospectively followed-up patients for 12months.

• The suspicion of an acute stroke was confirmed by brain MRI in 10 (28%) out of 36 PAPS patients [mean age 41 years old (S.D.13.4), female (70%)].
• In this study, 60% of these patients were <50 years old.
• A history of previous venous thrombosis was observed in 6 out of the 10 patients and were receiving vitamin K antagonist (VKA), with INR target 2-3; 1 patient had a history of a previous arterial event receiving treatment with VKA target INR 2-3 plus low dose aspirin (LDA), and 1 patient had a history of previous pregnancy morbidity receiving only LDA.
• For patients receiving VKA, time in therapeutic range was 77.7 (S.D.6.6).
• In patients with confirmed stroke, hypercholesterolemia was significantly higher when compared to those without (p < 0.05).
• Likewise, a significantly higher rate of anti-ß2GPI antibodies (IgG/IgM)(p < 0.05) and higher aGAPSS values was found in patients with a confirmed stroke [mean aGAPSS 8.9(S.D.4.7) vs mean aGAPSS6.4(S.D.2.5);p :< 0.05].