PMID- 20506512
OWN - NLM
STAT- MEDLINE
DCOM- 20100729
LR  - 20151119
IS  - 1529-0131 (Electronic)
IS  - 0004-3591 (Linking)
VI  - 62
IP  - 7
DP  - 2010 Jul
TI  - Asymptomatic myocardial ischemic disease in antiphospholipid syndrome: a 
      controlled cardiac magnetic resonance imaging study.
PG  - 2093-100
LID - 10.1002/art.27488 [doi]
AB  - OBJECTIVE: Antiphospholipid syndrome (APS) may cause coronary thrombosis. This 
      study was undertaken to determine the prevalence of silent myocardial disease in 
      patients with APS, using late gadolinium enhancement (LGE) of cardiac magnetic 
      resonance imaging (CMRI). METHODS: Twenty-seven consecutive patients with APS and 
      81 control subjects without known cardiovascular disease underwent CMRI. The 
      prevalence of occult myocardial ischemic disease, as revealed by LGE, was 
      compared between patients with APS and controls, and factors associated with 
      myocardial disease were identified in patients with APS. RESULTS: Myocardial 
      ischemic disease, as characterized by LGE on CMRI, was present in 8 (29.6%) of 27 
      patients with APS, and imaging with LGE showed a typical pattern of myocardial 
      infarction (MI) in 3 patients (11.1%). The myocardial scarring revealed on CMRI 
      was not detected by electrocardiography or echocardiography. Although both 
      patients with APS and control subjects shared a low risk of cardiovascular 
      events, as calculated with the Framingham risk equation (mean +/- SD 5.1 +/- 8.2% 
      and 6.5 +/- 7.6%, respectively, for the absolute risk within the next 10 years; P 
      = 0.932), the prevalence of myocardial ischemia was more than 7 times higher in 
      patients with APS (P = 0.0006 versus controls). No association was found between 
      myocardial disease in patients with APS and classic coronary risk factors. The 
      presence of myocardial scarring tended to be more closely associated with 
      specific features of APS, such as duration of the disease, presence of livedo, 
      and positivity for anti-beta(2)-glycoprotein I antibodies. CONCLUSION: The 
      finding of a significant and unexpectedly high prevalence of occult myocardial 
      scarring in patients with APS indicates the usefulness of CMRI with LGE for the 
      identification of silent myocardial disease in such patients.
FAU - Sacre, Karim
AU  - Sacre K
AD  - Bichat-Claude Bernard Hospital, Assistance Publique-Hopitaux de Paris, and Paris 
      7 University, Paris, France.
FAU - Brihaye, Benoit
AU  - Brihaye B
FAU - Hyafil, Fabien
AU  - Hyafil F
FAU - Serfaty, Jean-Michel
AU  - Serfaty JM
FAU - Escoubet, Brigitte
AU  - Escoubet B
FAU - Zennaro, Maria-Christina
AU  - Zennaro MC
FAU - Lidove, Olivier
AU  - Lidove O
FAU - Laissy, Jean-Pierre
AU  - Laissy JP
FAU - Papo, Thomas
AU  - Papo T
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Arthritis Rheum
JT  - Arthritis and rheumatism
JID - 0370605
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Adult
MH  - Antiphospholipid Syndrome/*diagnosis/epidemiology
MH  - Comorbidity
MH  - Coronary Artery Disease/*diagnosis/epidemiology
MH  - Echocardiography
MH  - Electrocardiography
MH  - Female
MH  - France/epidemiology
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Myocardial Infarction/*diagnosis/epidemiology
MH  - Predictive Value of Tests
MH  - Risk Factors
EDAT- 2010/05/28 06:00
MHDA- 2010/07/30 06:00
CRDT- 2010/05/28 06:00
PHST- 2010/05/28 06:00 [entrez]
PHST- 2010/05/28 06:00 [pubmed]
PHST- 2010/07/30 06:00 [medline]
AID - 10.1002/art.27488 [doi]
PST - ppublish
SO  - Arthritis Rheum. 2010 Jul;62(7):2093-100. doi: 10.1002/art.27488.