Resumo

GOMEZ PADRON, María Virginia; TORRES, Wilfredo; GOMEZ PADRACUTEN, Enrique Ivo  e  MERIDA ALVAREZ, Oyantay. Should the antiphospholipid syndrome be considered as a new cardiovascular risk factor. Rev cubana med [online]. 2008, vol.47, n.1. ISSN 0034-7523.

The antiphospholipid syndrome is a thrombophilic state due to the presence in blood of antibodies directed against the prothrombin-phospholipid complex or against clotting factors-phospholipids affecting the conversion of the first one into thrombin and the activation of the second. A review was made to know if the antiphospholipid syndrome should be considered as a new cardiovascular risk factor, to determine the mechanisms of production of thrombosis, the new diagnostic criteria of the syndrome, and to describe the affections it produces at the level of the coronary endothelium and of the valvular and mural endocardium. It was concluded that the antiphospholipid syndrome should be considered as a new cardiovascular risk factor, since the antiphospholipid antibodies are able to generate a risk for heart affections at the endocardium level and to cause insufficiencies, valvular stenoses and intracavitary mural thrombosis. The antiphospholipid antibodies at the level of the valvular and mural endocardium produce transformations that turn them into a triggering source of systemic and pulmonary emboli. These antibodies at the level of the coronary endothelium may induce acute coronary syndromes with elevation of ST and without it, as well as to occlude the revascularized bridges and intracoronary devices. The antiphospholipid antibodies at the level of the microcirculation endothelium may trigger microthrombosis or thrombosis of the middle and large pulmonary branches, and secondarily provoke pulmonary hypertension. They can also develop intracoronary atherosclerosis and help to trigger chronic ischemic heart disease.

Palavras-chave : Antiphospholipid syndrome; antiphospholipid antibodies; coronary thrombosis; insufficiency and valvular stenosis.

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