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Relationship between cerebrovascular and valvular manifestations in a Serbian cohort of patients with antiphospholipid syndrome

1, 2, 3, 4, 5, 6

 

  1. Clinic of Internal Medicine, University Hospital Center Bezanijska Kosa, Belgrade; and Faculty of Medicine, University of Belgrade, Serbia. drsaska@yahoo.com
  2. Clinic of Internal Medicine, University Hospital Center Bezanijska Kosa, Belgrade, Serbia.
  3. Clinic of Internal Medicine, University Hospital Center Bezanijska Kosa, Belgrade, Serbia.
  4. Clinic of Internal Medicine, University Hospital Center Bezanijska Kosa, Belgrade, Serbia.
  5. Department of Neurology, University Hospital Center Zemun, Belgrade, Serbia.
  6. Clinic of Internal Medicine, University Hospital Center Bezanijska Kosa, Belgrade; and Faculty of Medicine, University of Belgrade, Serbia.

CER11037
2018 Vol.36, N°5
PI 0850, PF 0855
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PMID: 29846156 [PubMed]

Received: 10/12/2017
Accepted : 12/02/2018
In Press: 24/05/2018
Published: 26/09/2018

Abstract

OBJECTIVES:
Antiphospholipid syndrome (APS) may manifest itself as a primary (PAPS) or secondary disease, most commonly in the context of systemic lupus erythematosus (SLE) with various neurological and cardiac manifestations in its occurrence. The objective of this study was to investigate the relationship between cerebrovascular (stroke and transient ischaemic attack (TIA)) and valvular manifestations in a Serbian cohort of APS patients.
METHODS:
This is cross sectional study of 508 APS patients: 360 PAPS and 148 APS patients associated with SLE (SAPS). aPL analysis included detection of anticardiolipin antibodies (aCL: IgG/IgM), anti-ß2glycoprotein I (ß2GPI: IgG/IgM), and LA.
RESULTS:
The prevalence of valvular manifestations (valvular vegetations and valvular thickening and dysfunction not related to age) in our cohort was significantly higher in SAPS group. (28.4% vs. 8.6%, p=0.0001). Age was strong predictor for stroke and TIA occurrence in both groups as well as gender (stroke more likely occurred in male SAPS and TIA in male PAPS patients). Presence of ß2GPI IgG in SAPS patients was significantly related to stroke (p=0.018), whereas ß2GPI IgG negative PAPS patients were more prone to TIA. Valvular manifestations were significantly related to TIA in both groups of patients and were independent risk factors for TIA in PAPS (OR 3.790 CI 1.597-8.998 p=0.003).
CONCLUSIONS:
In this cross-section analysis of a large cohort of Serbian APS patients, there was a strong relationship between valvular and cerebrovascular manifestations, suggesting a more cautious approach regarding neurological symptoms, especially in PAPS patients with valvular vegetations present.

Rheumatology Article