The following is a summary of “Heart valve disease in primary antiphospholipid syndrome,” published in the August 2023 issue of Rheumatology by Niznik et al.
There is limited research on the clinical factors that affect the course of Antiphospholipid syndrome(APS) -associated heart valve disease (HVD) in patients with primary APS (pAPS). Researchers performed a retrospective study to investigate clinical characteristics and outcomes of APS-associated HVD.
The study compared the clinical course of 33 pAPS patients with HVD to 128 pAPS patients with normal heart valves. In pAPS-HVD patients, more cerebrovascular events (56.3% vs. 25%, P=0.005) and livedo reticularis (24.2% vs. 7.8%, P=0.013) occurred compared to pAPS-controls. Catastrophic-APS (CAPS) (12.1% vs. 2.4%, P=0.034), recurrent thrombosis (33.3% vs. 4.7%, P<0.001), and advanced therapy needs were higher. Anti-B2GPI-IgG (84.8% vs. 63.2%, P=0.034), anti-cardiolipin IgG (90.9% vs. 64.8%, P=0.005), and triple positive aPL (75.8% vs 56.5%, P=0.047) were more common in pAPS-HVD. Valve surgery in 10 pAPS-HVD patients was associated with male gender, smoking, arterial limb ischaemia, and livedo reticularis.
The study concluded that pAPS-HVD patients represented severe APS course, CAPS, thrombosis, IgG aPL antibodies, and triple positivity, indicating a high-risk APS subgroup.
