Analiza kardiovaskularnih događaja kod bolesnika sa primarnim i sekundarnim antifosfolipidnim sindromom
Analysis of cardiovascular events in patients with primary and secondary antiphospholipid syndrome
Author
Đoković, AleksandraMentor
Simić, Dragan
Stojanović, Ljudmila
Committee members
Pavlović, Siniša
Ristić, Arsen

Matić, Mihailo
Metadata
Show full item recordAbstract
UVOD: Antifosfolipidni sindrom (AFS) je autoimuno oboljenje koje se odlikuje
prisustvom antifosfolipidnih antitela (aFL) i najmanje jednom kliničkom
manifestacijom, najčešće trombozom vena i/ili arterija i akušerskom patologijom.
Antifosfolipidni sindrom se može javiti u primarnom i sekundarnom obliku.
Prisustvo primarnog AFS (PAFS) se definiše ukoliko je odsutna osnovna
bolest, dok se sekundarni AFS ispoljava u okviru nekog drugog patološkog stanja,
odnosno kada se znaci i simptomi AFS pojavljuju kod bolesnika sa nekom
autoimunom bolešću a najčešće u sistemskom eritemskom lupus (SEL).
CILJEVI RADA: Ciljevi ove studije bili su da se odredi učestalost kardiovaskularnih
događaja (uključujući valvularne promene, trombozu srca, koronarnu
bolest, poremećaje ritma i sprovođenja) kod bolesnika sa PAFS i SAFS i
izvrši uporedna analiza rezultata između ovih grupa, da se odredi da li postoji
korelacija između nivoa antifosfolipidnih antitela (aFL) i pojave određenih kardiovaskularnih...
događaja i da se ustanovi da li određeni tip aFL ima potencijalni
prediktivni značaj za nastanak kardiovaskularnih događaja.
MATERIJAL I METODE: Ova kohortna studija obuhvatila je grupu od
101 PAFS i 80 SAFS bolesnika. Svim bolesnicima učinjen je klinički pregled koji
je obuhvatio transtorakalni ehokardiografski pregled, određivanje stepena endotelne
disfunkcije merenjem vazodilatacije brahijalne arterije izazvane protokom
(FMD), ultrazvučni pregled karotidnih arterija u cilju određivanja debljine
intime i medije (cIMT) i 24h HOLTER monitoring EKG-a. Svim bolesnicima
određeni su laboratorijski pokazatelji AFS-a (antifosfolipidnih antitela - aFL):
antikardiolipinska antitela (aKL IgG, IgM klase), anti ß-2 glikoprotein I antitela
(anti β2-GPI) (IgG ili IgM klase) i lupus antikoagulans (LA)...
INTRODUCTION: Antiphospholipid syndrome (APS) or Huges Syndrome
represents a systemic autoimmune disorder characterized by arterial
and/or venous thrombosis, multiple and recurrent fetal losses and elevated levels
of antiphospholipid antibodies (aPL), such as lupus anticoagulant (LA), anticardiolipin
antibodies (aCL) and anti-ß2GPI antibodies. This syndrome is considered
primary (PAPS) if unassociated with any other connective tissue disease
or secondary (SAPS) if it appears in association with other autoimmune disorders,
mainly systemic lupus erythematosus (SLE)
OBJECTIVES: The major objectives of the present study were: 1) to analyze
and report the incidence of the various cardiac manifestations in patients
with APS comparing PAPS and SAPS groups, 2) to investigate their possible
relationship to certain aPL type or level, 3) to establish possible predictive role
of aPL for certain manifestations.
MATERIAL AND METHODS: This cohort study includes a total of 180
(Caucasian...s) APS patients; (averaged age 48.69±13.16 years), 159 female
(87.8%) i 22 male (12.2%), 101 were PAPS patients and 80 had APS associated
with SLE. All patients have undergone complete standard transthoracic echocardiography
exam, followed by the endothelial dysfunction estimation by the
method of flow dilatation mediated dilatation of brachial artery (FMD), carotid
ultrasound with the measurement of intima media thickness (cIMT) and 24 h
ambulatory HOLTER ECG monitoring. All patients were evaluated for the presence
of aPL: LA, aCL IgG/IgM, anti- ß2GPI IgG/IgM.
RESULTS: Prevalence of valvular changes (involving valvular dysfunction
and thickness of valvular leaflets) was 26.7% in PAPS and 42.5% in SAPS group
(p=0.026). There was no significant relationship between valvular changes and type and level of aPL present...