Antiphospholipid Syndrome
Antiphospholipid syndrome (APS) is an autoimmune disease that effects
multisystems and organs; develops as a result of antiphospholipid antibodies
(aPL) dependent with vascular thromboses and/ or pregnancy complications.
Firstly in the early 1980s, APS was described based on the observation that
thrombosis and pregnancy losses were seen more frequently in SLE patients who
had lupus anticoagulant (LA), anti-cardiolipin antibodies. The prevalence of
APS is approximately 50/100 000 of the population. The prevelance of APS
increases with age; the prevelance especially high in older patients with a
chronic disease. Antiphospholipid syndrome can be secondary or primary; secondary APS
is associated with other autoimmune disease, particularly systemic lupus
erythematosus (SLE) and primary APS is assosiated no autoimmune disease. Clinical thrombotic vascular complications are
often associated with antiphospholipid antibodies that can occur autoimmune
disease, viral,bacterial, protozoal, fungal infections, malignancies,
drug. Patients who have antiphospholipid antibodies (aPL) are at risk of
developing thrombocytopenia, venous and arterial thrombosis, and recurrent
fetal loss. Thrombosis can involve both arteriel and venous systems, tend to
recurrence and can occur in the same system. In the studies, thrombotic
manifestations of APS is seen mostly by venous thromboembolism with
approximately 60% ratio. APS is a syndrome has multisystemic involvement due to
acquired hypercoagulable state and associated with various thrombotic and
nonthrombotic cardiac manifestations. The cardiac involvement in APS patients
is seen in a wide spectrum including ischemic heart disease, right or left
ventricular dysfunction, pulmonary hypertension, intracardiac thrombosis and
endomyocardial fibrosis due to thrombosis in the coronary or microvascular
circulation.The most common form of cardiac involvement in APS is heart valve
disease. Primary and secondary cardiovascular prevention strategies should be
implemented basically with lifestyle changes firstly and involved specific
treatment algorithm of cardiovascular risk factors.
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