Evaluation of: Urbanus RT, Siegerink B, Roest M, Rosendaal FR, de Groot PG, Algra A: Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study: a case–control study. Lancet Neurol. 8(11), 998–1005 (2009). In a multicenter, population-based case-control study of women younger than 50 years of age, 175 patients with ischemic stroke, 203 patients with myocardial infarction and 628 healthy controls were analyzed. Lupus anticoagulant positivity increased the odds ratio (OR) of ischemic stroke (OR: 43.1; 95% CI: 12.2-152) and myocardial infarction (OR: 5.3; 95% CI: 1.4-20.8). Moreover, additional traditional thrombosis risk factors, such as smoking or oral contraceptives, further increased the OR of ischemic stroke and myocardial infarction in lupus anticoagulant-positive patients, supporting the evidence in support of a multifactorial nature of thrombosis in antiphospholipid antibody-positive patients.