Rapidly progressive coronary artery disease as the first manifestation of antiphospholipid syndrome
Abdullah Sayied Abdullah1, Hatim Yagoub, Thomas J Kiernan
1Department of Cardiology, University Hospital Limerick, Limerick, Ireland.
Insights
Antiphospholipid syndrome (APS) can cause aggressive coronary artery disease (CAD) even without traditional risk factors. Early diagnosis through autoantibody screening is crucial for managing this autoimmune disorder.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Antiphospholipid syndrome (APS) is an autoimmune disorder associated with thrombosis and cardiovascular complications.
- Coronary artery disease (CAD) risk is elevated in APS patients, including valvular heart disease and ventricular thrombi.
Observation:
- A 61-year-old woman presented with severe, aggressive CAD in native and graft vessels, necessitating multiple interventions.
- Her CAD severity was disproportionate to her conventional cardiovascular risk factors.
Findings:
- Autoantibody screening revealed strongly positive anticardiolipin and β2 glycoprotein-I antibodies.
- These findings led to a diagnosis of antiphospholipid syndrome.
Implications:
- This case highlights the importance of considering APS in patients with unexplained aggressive CAD.
- Timely diagnosis of APS is critical for appropriate management and prevention of thrombotic events.
- Further research into the cardiovascular manifestations of APS is warranted.
Abstract:
Antiphospholipid syndrome (APS) is an autoimmune multisystem disorder characterised by high incidence of arterial and venous thrombosis. Cardiovascular manifestations also include valvular heart disease, ventricular thrombi and higher risk for coronary artery disease (CAD). In this case report, we describe a 61-year-old woman who had no significant risk factors for CAD, and presented with aggressive disease in native and graft vessels that required multiple coronary interventions. The extent of her aggressive CAD could not be explained by her risk factors profile. Therefore autoantibodies screening was carried out and showed a strongly positive anticardiolipin and β2 glycoprotein-I antibody, and hence a diagnosis of antiphospholipid syndrome was made.
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