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09-01-2022 | Antiphospholipid syndrome | Adis Journal Club | Article

Rheumatology and Therapy

Primary Antiphospholipid Syndrome with and Without Acute Myocardial Infarction/Angina: A Cross-Sectional Study

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Authors: Jozélio Freire de Carvalho & Carlos Ewerton Maia Rodrigues

Abstract

Introduction

Acute myocardial infarct/angina (AMI-A) is a possible complication in primary antiphospholipid syndrome (pAPS) patients. This study compares data obtained from pAPS patients with and without AMI-A.

Methods

This cross-sectional study of 66 (85.2% female) pAPS patients (Sidney criteria). Demographics, clinical data, medication use, and antiphospholipid antibodies were evaluated. Patients were divided into two groups: pAPS with AMI-A and pAPS without AMI-A.

Results

Sixty-six patients with primary APS (six with AMI-A and 60 without AMI-A) were selected. They were similar for demographics, disease duration, and anthropometrics (p > 0.05). Patients with AMI-A compared to those patients without AMI-A had more frequently dyslipidemia (66 vs. 28%, p = 0.05), systemic hypertension (83 vs. 37%, p = 0.02), and increased levels of lipoprotein (a) (116 ± 67 vs. 36 ± 35 mg/dl, p = 0.0002). Interesting, current physical activity (66.7 vs. 23%, p = 0.04) was more seen in the first group when compared to the second one. Patients with AMI-A used more statins (66 vs. 22%, p = 0.017) and acetylsalicylic (100 vs. 28%, p = 0.05). Higher median levels of IgM anticardiolipin antibodies [70 (0–120) vs. 9 (0–120), p = 0.03] were observed in the first group.

Conclusions

pAPS patients and AMI-A have distinct clinical and laboratory spectra from those without AMI-A. It is characterized by dyslipidemia and hypertension, hyper lipoprotein(a), and a lower IgM anticardiolipin frequency.

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Key Summary Points

APS is associated with higher rates of cardiovascular disease.

About 2.8% of patients with APS may develop into acute myocardial infarction (MAI).

The present study compared APS patients with and without MAI-angina; the first group showed a higher frequency of dyslipidemia, hypertension, hyper lipoprotein(a), and a lower IgM anticardiolipin frequency.