Cardiovascular manifestations in patients with antiphospholipid syndrome: issues of diagnosis and management

I.Yu. Golovach, Ye.D. Yehudina


Antiphospholipid syndrome (APS) is an autoimmune systemic disease characterized by recurring thrombotic events and/or pregnancy pathology associated with the presence of antiphospholipid antibodies. Other possible clinical manifestations associated with antiphospholipid antibodies are represented by the cardiovascular system involvement. The pathogenetic features of this clinical condition are immunologically mediated and/or associated with an increased risk of thrombosis and may be explained more clearly by mechanisms such as inflammation, complement and thrombocyte activation. Involvement of the cardiovascular system in APS includes a wide range of clinical manifestations: valve abnormalities (non-bacterial vegetation, thickening and dysfunction), coronary heart disease, intracardiac thrombosis and accelerated coronary atherosclerosis. In addition, APS can also cause myocardial damage, pulmonary hypertension, left and right ventricular dysfunction. Among this spectrum, valve involvement is the most common manifestation of cardiovascular disease in patients with APS and is about 30 %. Due to the high prevalence of cardiac involvement in APS, clinicians should have a high suspicion index in order to reduce the incidence of cardiovascular complications. Prevention strategies need to be balanced based on the global risk profile for cardiovascular disease.


antiphospholipid syndrome; antiphospholipid antibodies; thrombosis; cardiovascular diseases; atherosclerosis; valve defects; myocardial infarction; pulmonary hypertension


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