Antiphospholipid syndrome combined with acute coronary syndrome

Abstract

Rationale:Antiphospholipid syndrome (APS) combined with acute coronary syndrome (ACS) is rarely reported.Patient concerns:One male patient with APS was admitted to our hospital, who had recent unstable angina (UA).Diagnosis:The preliminary diagnosis of ACS and UA (BraunwaldiB) was then made.Interventions:This patient received secondary preventative therapy for coronary heart disease (CHD) in combination with percutaneous transluminal coronary angioplasty (PTCA) and implantation of NeoVas Bioresorbable Coronary Scaffold.Outcomes:The patient was followed up, without new UA episodes were observed at 6 months, 1 year, and 2 year after surgery, respectively.Lessons:It was thus concluded that percutaneous coronary intervention (PCI) is effective for APS patients and NeoVas scaffold implantation is presumed safe.

Antiphospholipid syndrome and valvular heart disease, a complex scenario of thrombotic events, a case report

“…APS is also associated with acute myocardial infarction (AMI). This thromboembolic state caused by, endothelial cell activation, direct inhibition of the activated protein C pathway, abnormalities in platelet function and complement activation can predispose to cardiovascular events [6,17]. Up to 5.5% of cases with AMI in young individuals are secondary to APS.…”

“…Up to 5.5% of cases with AMI in young individuals are secondary to APS. When a stent is used in a patient with APS, the antiphospholipid antibody on intima in the stent promotes atherosclerosis, restenosis as well as vein graft disease [ 17 – 19 ].…”

Case of an unusual diagnosis of primary antiphospholipid syndrome with multiple clinical complications

“…Acute coronary syndrome is uncommon in young APS patients without traditional risk factors. APS may predispose to accelerated atherosclerosis; however, cases of myocardial infarction due to microthrombosis have been described [ 8 ]. Regarding the patient’s aPL profile, the presence of more than one antiphospholipid antibody, the high titer and the persistent positivity associate with high risk for thrombosis [ 9 ].…”

The Etiology of the Thrombotic Phenomena Involved in the Process of Coronary Artery Disease—What Is the Role of Thrombophilic Genes in the Development of This Pathology?

“…Antiphospholipid syndrome (APS) is a hypercoagulable condition defined by recurrent thrombotic episodes, including deep vein thrombosis (DVT), pulmonary embolism, placental thrombosis leading to miscarriage or arterial thrombosis, all in the presence of circulating antiphospholipid antibodies (APA). For the diagnosis of APS, the patient must have one of the following clinical presentations: arterial or venous thrombosis, pregnancy loss or thrombocytopenia, associated with at least one of the following laboratory criteria: presence of lupus antibodies, moderate/high titer of IgG/IgM anticardiolipin antibodies or IgG/IgM anti-glycoprotein B2 antibodies; each confirmed on two separate occasions with a minimum interval of 12 weeks [62][63][64].…”

“…Furthermore, antiphospholipid antibodies that bind to endothelial cells inhibit prostacyclin secretion, leading to increased platelet adhesion and TF release by vascular endothelium and monocytes. As a result, protein C activity is inhibited, favoring further secretion of IAP, leading to inhibition of the fibrinolytic system [62][63][64]. A study by Gurlek et al, which included patients with CAD and APS who were treated by percutaneous coronary intervention (PCI), showed that restenosis rates at 1-year follow-up were significantly higher for those patients who had moderate or high titers of anticardiolipin antibodies.…”