SAT0442 Risk factors for heart valve diseases in patients with antiphospholipid syndrome

Background Antiphospholipid syndrome (APS) patients are known to be at a high risk of heart valve diseases (HVDs), however, risk factors of HVDs in APS patients is unclear. Objectives The purpose of this study is to elucidate risk factors for HVDs in patients with APS. Methods We reviewed consecutive APS patients diagnosed according to the Sydney criteria in 2006 who had been followed in Keio University Hospital in October 2017. The presence of HVDs was identified by the latest transthoracic and/or transesophageal echocardiography. HVDs were defined any kind of valve diseases such as mitral valve regurgitation (MR) and stenosis more than mild degree, aortic valve regurgitation (AR) and stenosis more than mild degree and Libman-Sacks endocarditis. Antiphospholipid antibodies (aPLs) included lupus anticoagulant (LA), anticardiolipin antibodies (aCL), and anticardiolipin β2-glycoprotein I complex antibodies (aCL-β2GPI). We divided the patients into two groups by the presence of HVDs, and evaluated the risk factors of them. Results Fifty-five APS patients were identified. Among them, 43 patients underwent echocardiography and enrolled in the analysis. Six patients were primary APS, 36 were secondary APS with systemic lupus erythematosus, and one with Sjogren syndrome. HVDs were detected in 26 (60.5%) patients including 20 patients with MR, 8 patients with AR and a patient with Libman-Sacks endocarditis. The use of prednisolone, miscarriage episodes and the presence of arterial or venous thrombosis in patients with HVDs did not differ from those without HVDs. Immunologically, there was no significant difference in anti-double-stranded DNA antibody, anti-Smith antibody, anti-ribonucleoprotein antibody, anti-SSA/La antibody and anti-SSB/Lo antibody between patients with or without HVDs. While the positivity of aCL or aCL-β2GPI was not different between patients with HVDs and those without, positive LA was much higher in patients with HVDs and in patients with MR than those without (88.5% vs 35.3%, p Conclusions Positive LA test and positivity for 2 or more tests of aPLs are risk factors for HVDs in patients with APS. Regular monitoring cardiac ultrasonography is needed in those patients. Disclosure of Interest None declared