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Coronary and valvular syndromes and antiphospholipid antibodies
1Department of Autoimmune Diseases, Hospital Clínic, Villarroel, 170, 08036 Barcelona, Catalonia, Spain. rcervera@clinic.ub.es
Insights
Antiphospholipid syndrome (APS) is linked to various heart conditions like coronary artery disease and valve issues, often due to blood clots. Understanding these cardiac features is crucial for managing APS patients with anticoagulant therapy.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Antiphospholipid syndrome (APS) is an autoimmune disorder associated with a prothrombotic state.
- Cardiac manifestations are increasingly recognized in APS patients, presenting diagnostic challenges.
- These cardiac issues can mimic other conditions like rheumatic fever or endocarditis.
Purpose of the Study:
- To review the primary cardiac manifestations associated with antiphospholipid antibodies (aPLs).
- To highlight the clinical relevance of these cardiac features for healthcare providers.
Main Methods:
- This is a review article.
- It synthesizes existing literature on cardiac manifestations in APS.
Main Results:
- Common cardiac involvements include coronary artery disease, valvular disease, cardiomyopathy, and intracardiac thrombosis.
- Thrombotic events in coronary or valvular circulation are the main underlying pathology.
- APS-related coagulopathy necessitates careful antiplatelet and anticoagulant management.
Conclusions:
- Cardiac manifestations are a significant clinical aspect of APS.
- Recognition and appropriate management of these features are essential for patient care.
- Further research into the specific mechanisms and optimal treatments for cardiac APS is warranted.
Abstract:
Since the recognition of the antiphospholipid syndrome (APS), a large number of cardiac manifestations have been reported in association with these antibodies, including coronary artery and valvular disease, cardiomyopathy, and intracardiac thrombosis. Most of these manifestations are explicable on the basis of thrombotic lesions either in the coronary circulation or on the valves and may mimic other similar conditions, such as rheumatic fever or infectious endocarditis. The APS coagulopathy in these patients requires the careful and judicious use of appropriate antiaggregant and anticoagulant therapy. In this review article, the focus will be on the main cardiac features related to the presence of antiphospholipid antibodies (aPLs), which may be of interest to clinicians.
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