Received on November 17, 2005
Accepted on March 8, 2006

Hemostasis and Thrombosis

Anti-Cardiolipin Antibodies and Overall Survival in a Large Cohort: Preliminary Report

¹ Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
² Institute of Medical and Chemical Laboratory Diagnostics, and Department of Clinical Pharmacology, Division of Haematology and Immunology, Medical University of Vienna, Vienna, Austria
³ Department of Clinical Pharmacology, Division of Haematology and Immunology, Medical University of Vienna, Vienna, Austria
⁴ Department of Internal Medicine I, Division of Haemostaseology, Medical University of Vienna, Vienna, Austria

^* To whom correspondence should be addressed. E-mail: helmut.rumpold{at}meduniwien.ac.at.

Background: Anti-cardiolipin antibodies have been associated with both arterial and venous thrombosis, but their overall impact on all-cause or vascular mortality is unknown. In this study, we evaluated the influence of anti-cardiolipin antibodies on all-cause and vascular mortality.

Methods: All individuals who fulfilled the inclusion criteria (completeness of data, no admission from an intensive care unit, unique identification with name and date of birth) and whose anti-cardiolipin antibodies were measured between October 2002 and February 2004 were included in this study (n = 4756; 64% female; median age, 46 years). Death/survival and cause of death were obtained from the Austrian Death Registry. The median observation period was 1.5 years, and the study comprised 7189 person-years.

Results: During the study period, 184 patients (3.9%) died. There were no associations between either anti-cardiolipin IgM or IgG antibodies and both vascular death and noncancer mortality as outcome variables in a Cox regression analysis adjusted for age and sex. In contrast, the risk of cancer-related mortality was increased 2.6-fold.

Conclusions: Anti-cardiolipin antibodies are associated with cancer mortality, likely as an epiphenomenon of malignancy. but they are not predictive of vascular mortality or noncancer mortality. Hence, although a clear association between anti-cardiolipin antibodies and (mostly nonfatal) vascular events has been described in the literature, our data indicate that this finding is not necessarily associated with an increase in vascular mortality.