title: Patients with primary antiphospholipid syndrome and coronary microvascular dysfunction--a distinct clinical subset.
abstract: Morbidity of patients with cardiac syndrome X (CSX) is high. Impairment of microvascular endothelial function has been suggested to be a mechanism of the disease. The study was undertaken to assess some of the characteristics of patients with primary antiphospholipid syndrome (pAPS) and CSX.
  
  
  METHODS
  We studied 36 patients with CSX, 14 patients having pAPS and 10 healthy controls. Patients evaluation included: clinical examination, 12-lead ECG, effort treadmill test (protocol Bruce modified), determination of plasma triglycerides, cholesterol, antiphospholipid antibodies (APLA). There were determined as markers of the inflammatory state: serum phospholipase (PL-A2) and peripheral neutrophils activity.
  
  
  RESULTS
  Patients with pAPS presented normal values of serum cholesterol and triglycerides levels, normal PL-A2 activity, moderate superoxide anion generation. Patients without APLA presented hyperlipidemia, increased PL-A2 activity, increased superoxide anion generation. During the follow-up period we found a correlation between P1-A2 activity and ischemic episodes, but only in patients with CSX and pAPS there were registered cardiovascular events.
  
  
  CONCLUSIONS
  Patients with SCX and pAPS represent a distinct clinical subset, being characterized by minimal inflammation, absence of usual risk factors for coronary heart disease, more severe prognosis related to recurrent thromboses and the need for early anticoagulant therapy.
authors.affiliation: St. Pantelimon Clinical Emergency Hospital, Department of Internal Medicine, Bucharest, Romania.
authors.forename: Cristina
authors.initials: C
authors.lastname: Tănăseanu
authors.forename: Elena
authors.initials: E
authors.lastname: Moldoveanu
authors.forename: St
authors.initials: S
authors.lastname: Tănăseanu
authors.forename: Monica
authors.initials: M
authors.lastname: Popescu
authors.forename: Alina
authors.initials: A
authors.lastname: Dumitraşcu
authors.forename: Isabela
authors.initials: I
authors.lastname: Tamşulea
authors.forename: Antoaneta
authors.initials: A
authors.lastname: Urban
authors.forename: Viorica
authors.initials: V
authors.lastname: Grecu
authors.forename: Monica
authors.initials: M
authors.lastname: Neagu
authors.forename: Gabriela
authors.initials: G
authors.lastname: Manea
authors.forename: Daciana
authors.initials: D
authors.lastname: Marta
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D017566:Microvascular Angina / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D010740:Phospholipases / Q000097:blood; D011379:Prognosis; D014280:Triglycerides / Q000097:blood
chemical_list: D017152:Antibodies, Antiphospholipid; D014280:Triglycerides; D002784:Cholesterol; D010740:Phospholipases