Antiphosholipid syndrome and the risk of myocardial infarction: current evidence and uncertainties.

Antiphosholipid syndrome and the risk of myocardial infarction: current evidence and uncertainties. Kardiol Pol. 2019 Dec 06;: Authors: Lóczi L, Kappelmayer J, Tarr T, Bagoly Z Abstract Antiphospholipid syndrome (APS) encompasses a wide spectrum of disease manifestations that may prevail in the form of venous or arterial thrombosis or lead to pregnancy complications in the presence of persisting antiphospholipid (aPL) antibodies. Unlike in the case of congenital thrombophilias where venous thromboses are more likely to occur as compared to arterial events, aPL antibodies may cause thrombosis in both types of vascular system, often including the coronary or cerebral arteries leading to myocardial infarction (MI) or stroke. In this review we summarize the complex pathomechanisms leading to aPL-associated thrombosis and list challenges during the laboratory detection of these antibodies. Specific features of MI in APS patients are summarized based on a comprehensive literature search of available case reports. Preventive and treatment strategies are discussed based on current recommendations and most recent evidence. We conclude that the risk of MI in patients with APS is considerable and MI may be the first manifestation of the disease. MI in APS shows specific clinical features including relatively young age at presentation, no gender dominance, often normal coronaries without the sign of atherosclerosis, high risk of recurrent throm...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research