0410: Cardiovascular manifestations in antiphospholipid syndrome

Introduction Antiphospholipid syndrome (APLS) is defined by the occur-rence thrombosis, and/or obstetric morbidity associated with the presence of antiphospholipid antibodies. Cardiovascular manifestations of APLS are variable and some of them can be life threatening. Patients and Methods Retrospective study of patients with APLS (diagnosed according to Sidney classification criteria of 2006) in an Internal medicine department over a period of 14 years. Results Thirty-four patients with APLS had cardiovascular involvements (66.6%); 30 females and 4 males, with a mean age of 40.5 years (24-74 years). Cardiovascular involvements revealed the disease in 53% of cases. Venous thromboses were most frequent manifestation: deep-vein thrombosis (DVT) (12 cases), pulmonary embolism (5 cases), cerebral venous thrombosis (1 case), inferior vena cava thrombosis (1 case), portal vein thrombosis (1 case), superficial venous thrombosis (1 case) and central retinal vein occlusion (2 cases). Arterial thromboses were noted in 12 patients: stroke (9 cases), upper limb artery, renal artery and occlusion of central retinal artery (each in 1 patient). Acute coronary artery thrombosis was observed in one patient (myocardial infarction). Pericarditis was noted in 3 cases, valvular disease in 2 cases (an aortic and a mitral stenosis), and myocarditis in 1 patient. Anticardiolipin and anti-B2 glycoprotein I antibodies were positive in 47.1% and 52.8% of cases respectively. Anticoagulant therapy was prescribed in thrombotic cases. Pericarditis were treated with corticosteroids and patient with myoarditis had both corticosteroid and immunosuppressant agent. Conclusion DVP were the most frequent vascular manifestation in patients with APLS. Cardiac involvements are rare but serious. They can affect all parts of the heart but cardiac valvulopathy and coronary artery thrombosis are the most frequent.