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急性心肌梗死和年轻成年一过性抗心磷脂抗体升高伴可能的家族性高胆固醇血症：病例报告：抗心磷脂抗体与心肌梗死。

Acute myocardial infarction and transient elevated anticardiolipin antibody in a young adult with possible familial hypercholesterolemia: a case report : Anticardiolipin antibody and myocardial infarction.

机构信息

Department of Cardiology, Gansu Provincial Hospital, Lanzhou University, Lanzhou, 730000, People's Republic of China.

School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, 730000, People's Republic of China.

出版信息

BMC Cardiovasc Disord. 2019 Jun 27;19(1):156. doi: 10.1186/s12872-019-1135-y.

DOI:10.1186/s12872-019-1135-y
PMID:31248367
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6598355/
Abstract

BACKGROUND

Familial hypercholesterolemia (FH) can lead to premature coronary heart disease. Anticardiolipin antibody may be a contributor for thrombosis. Here, we report an adult with possible FH suffered from premature myocardial infarction that may be triggered by transient increased anticardiolipin antibody.

CASE PRESENTATION

A 29-year-old male had presented with a history of 2-h chest pain and numbness of left upper arm before 5 days. The electrocardiogram (ECG) had demonstrated inferior wall myocardial infarction (MI). Five days later he was admitted to our hospital and diagnosed as acute MI and possible FH (premature coronary heart disease, low density lipoprotein cholesterol of 5.90 mmol/L) with increased anticardiolipin antibody (up to 120 RU/ml). Other auto-antibodies including β2-glicoprotein antibodies IgM, IgA, IgG, lupus anticoagulant (LA), antinuclear antibodies, anti-myocardial antibody were normal. Coronary artery angiography (CAG) showed right coronary artery was total occlusion from the middle segment. Then he underwent percutaneous coronary intervention with a stent. Four days later, he was discharged with complete recovery. CAG showed intra-stent restenosis and anticardiolipin antibody level was normal and the patient had no any symptoms at 6-month follow-up.

CONCLUSIONS

Transient elevated anticardiolipin antibody may be a trigger or biomarker of cardiac thrombotic events in younger atherosclerotic patients.

摘要

背景

家族性高胆固醇血症（FH）可导致早发冠心病。抗心磷脂抗体可能是血栓形成的一个促成因素。在这里，我们报告了一例可能患有 FH 的成年患者发生早发心肌梗死，可能由短暂的抗心磷脂抗体增加所触发。

病例介绍

一名 29 岁男性，有 5 天前 2 小时胸痛和左上臂麻木的病史。心电图（ECG）显示下壁心肌梗死（MI）。5 天后，他被收入我院，诊断为急性 MI 和可能的 FH（早发冠心病，低密度脂蛋白胆固醇 5.90mmol/L），伴有抗心磷脂抗体增加（高达 120RU/ml）。其他自身抗体，包括β2-糖蛋白抗体 IgM、IgA、IgG、狼疮抗凝剂（LA）、抗核抗体、抗心肌抗体均正常。冠状动脉造影（CAG）显示右冠状动脉从中段完全闭塞。随后，他接受了支架置入的经皮冠状动脉介入治疗。4 天后，他完全康复出院。CAG 显示支架内再狭窄，抗心磷脂抗体水平正常，6 个月随访时患者无任何症状。

结论

年轻动脉粥样硬化患者心脏血栓事件的短暂性升高的抗心磷脂抗体可能是一个触发因素或生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d1/6598355/daed0b7baaf1/12872_2019_1135_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d1/6598355/171a89ffd635/12872_2019_1135_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d1/6598355/bd7333146b5e/12872_2019_1135_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d1/6598355/9fcbab780c72/12872_2019_1135_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d1/6598355/daed0b7baaf1/12872_2019_1135_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d1/6598355/171a89ffd635/12872_2019_1135_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d1/6598355/bd7333146b5e/12872_2019_1135_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d1/6598355/9fcbab780c72/12872_2019_1135_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7d1/6598355/daed0b7baaf1/12872_2019_1135_Fig4_HTML.jpg

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