Curr Probl Cardiol. 2021 Mar;46(3):100552. doi: 10.1016/j.cpcardiol.2020.100552. Epub 2020 Feb 20.
We present a case of acute myocardial infarction secondary to arterial thromboembolism in a 25-year-old man with systemic lupus erythematosus and antiphospholipid syndrome (APS). To our knowledge, based on the literature review, this patient is the youngest one with the acute coronary syndrome as a complication of APS. Acute myocardial infarction secondary to arterial thromboembolism is a rare presentation of APS. There are different recommended anticoagulation strategies in APS patients according to the presence of thrombosis of arterial or venous origin. Potential difficulties in the treatment may occur based on the clinical scenarios. A large number of APS patients require lifelong oral anticoagulation with vitamin K antagonists. Some non-vitamin K oral anticoagulants are being studied as drugs potentially useful in APS treatment. The recent studies suggest the role of aGAPSS score in assessing the risk of a recurrent thrombotic event as well as acute myocardial infarction in APS patients.
我们报告了一例系统性红斑狼疮和抗磷脂综合征(APS)患者发生动脉血栓栓塞导致的急性心肌梗死。据我们所知,基于文献复习,该患者是急性冠状动脉综合征作为 APS 并发症的最年轻病例。动脉血栓栓塞导致的急性心肌梗死是 APS 的一种罕见表现。根据动脉或静脉来源血栓形成的存在,APS 患者有不同的推荐抗凝策略。基于临床情况,治疗可能会出现潜在的困难。大量 APS 患者需要终生口服维生素 K 拮抗剂进行抗凝治疗。一些新型非维生素 K 口服抗凝剂正在被研究作为治疗 APS 潜在有用的药物。最近的研究表明 aGAPSS 评分在评估 APS 患者复发性血栓事件和急性心肌梗死风险中的作用。