Challenges in Revascularization in Patients With Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) markedly increases cardiovascular risk through inflammation and thrombophilia, which may be further intensified by antiphospholipid syndrome (APS).

A 52-year-old man with SLE presented with acute myocardial infarction, likely due to APS reactivation. He received timely reperfusion therapy followed by immunosuppressive treatment and anticoagulation, and he later underwent elective coronary artery bypass grafting with favorable recovery.

This case illustrates the interplay between immune activation, thrombosis, and severe coronary disease in patients with SLE and APS. It emphasizes the need for an integrated approach balancing reperfusion, immunosuppression, and surgical timing.

In lupus patients, myocardial infarction should raise suspicion of APS reactivation. Coordinated multidisciplinary care is essential for achieving good outcomes in complex autoimmune-related coronary disease.