Systemic lupus erythematosus (SLE) is characterized by a pancarditis involving pericardium, myocardium, endocardium and coronary arteries. Coronary artery disease may be due to arteritis or due to atherosclerosis. The aim of our study was the incidence of myocardial infarction in patients (pts) with SLE.
We studied 186 consecutive pts (168 females – 18 males, aged 51±12 years) with SLE. All the pts were evaluated with and electrocardiogram (ECG) and an echocardiogram. Seventeen pts had regional akinetic or hypokinetic segments and ECG findings implying myocardial infarction. Thirteen pts with myocardial infarction had undergone coronary angiography.
Seventeen pts (16 females – 1 male) from the total (9.1%) had myocardial infarction. In 9 the infarction was anterior, in 5 inferior, in 1 lateral and in 2 non-Q. Thirteen of these pts had coronary angiography and in 6 the coronary vessels were normal. In 4 cases subtotal occlusion in the left anterior descending coronary artery was detected and coronary angioplasty was performed with good long-term results. Of the 17 pts with myocardial infarction, 12 (70.6%) had increased antiphospholipid antibodies (APL) and 11 were less than 40 years old.CONCLUSIONS: Our results indicate that there is a raised incidence of myocardial infarction among pts with SLE, with greater prevalence in pts with increased APL. These findings suggest that APL possibly play a causative role in the development of these lesions. Coronary angioplasty may be useful in selective cases.
N.J. Pantazopoulos, None.