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      Coronary Artery Thromboses, Stent Thrombosis and Antiphospholipid Antibody Syndrome: Case Report

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          Abstract

          The antiphospholipid antibody syndrome (APS) is defined by a state of hypercoagulability secondary to an autoimmune disorder. There are evidences that approximately 2.8-5.5% of cases of acute myocardial infarction (AMI) in young individuals are secondary to APS. In this case report, three coronary artery thromboses occurring within a short period are described. Initially, there was an ST-segment elevation (STEMI) in the presence of coronary artery disease (CAD), with the vessel being treated with stent implantation. Thereafter, a subacute stent thrombosis occurred (high thrombotic load in almost all coronary arteries), which was treated with implantation of two stents. Subsequently, there was a new infarction owing to a new thrombosis in the native coronary artery. The treatment of APS in patients who developed thrombotic events is full anticoagulation from the initial stages maintained throughout life. The standard anticoagulant therapy is administration of vitamin K antagonists, such as warfarin.

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          Most cited references7

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          Evidence-based recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: Report of a Task Force at the 13th International Congress on Antiphospholipid Antibodies

          The antiphospholipid syndrome (APS) is defined by the presence of thrombosis and/or pregnancy morbidity in combination with the persistent presence of circulating antiphospholipid antibodies: lupus anticoagulant, anticardiolipin antibodies and/or anti-β2-glycoprotein I antibodies in medium to high titers. The management of thrombosis in patients with APS is a subject of controversy. This set of recommendations is the result of an effort to produce guidelines for therapy within a group of specialist physicians in Cardiology, Neurology, Hematology, Rheumatology and Internal Medicine, with a clinical and research focus on APS.
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            Epidemiology of the antiphospholipid antibody syndrome.

            The prevalence of antiphospholipid antibodies in normals and SLE patients is reviewed. The frequency of complications of antiphospholipid antibodies (thrombosis, pregnancy morbidity) in the literature and in the Hopkins Lupus Cohort is summarized. Copyright 2000 Academic Press.
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              Antiphospholipid Syndrome: Role of Vascular Endothelial Cells and Implications for Risk Stratification and Targeted Therapeutics.

              Antiphospholipid syndrome (APS) is an autoimmune disease characterized by venous thromboembolism, arterial thrombosis, and obstetric morbidities in the setting of persistently positive levels of antiphospholipid antibodies measured on 2 different occasions 12 weeks apart. Patients with APS are at increased risk for accelerated atherosclerosis, myocardial infarction, stroke, and valvular heart disease. Vascular endothelial cell dysfunction mediated by antiphospholipid antibodies and subsequent complement system activation play a cardinal role in APS pathogenesis. Improved understanding of their pathogenic function could help in the risk stratification of patients with APS and provide new molecular therapeutic targets.
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                Author and article information

                Journal
                Cardiol Res
                Cardiol Res
                Elmer Press
                Cardiology Research
                Elmer Press
                1923-2829
                1923-2837
                April 2018
                25 April 2018
                : 9
                : 2
                : 129-132
                Affiliations
                [a ]Real Hospital Portugues de Beneficiencia, Recife-PE, Brazil
                [b ]Hospital das Clinicas, Federal University of Pernambuco, Recife-PE, Brazil
                Author notes
                [c ]Corresponding Author: Dinaldo Cavalcanti Oliveira, Real Hospital Portugues de Beneficiencia, Hospital das Clinicas, Federal University of Pernambuco, Recife-PE, Brazil. Email: dinaldocardiol.br/dinaldo@ 123456pq.cnpq.br
                Article
                10.14740/cr661w
                5942245
                6386ebc6-c78d-4c82-8532-e3a0ae094e97
                Copyright 2018, Correia et al.

                This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 December 2017
                : 4 January 2018
                Categories
                Case Report

                acute myocardial infarction,antiphospholipid antibody syndrome,coronary artery disease,thromboses

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