In systemic lupus erythematosus (SLE), cardiovascular complications are among the
leading causes of death. Cardiovascular risk in SLE is even higher in the presence
of antiphospholipid antibodies or secondary antiphospholipid syndrome (APS). The aim
of this retrospective, single-center study was to investigate the occurrence of antiphospholipid
antibodies and non-thrombotic cardiac manifestations in 369 SLE patients. We also
assessed the clinical and laboratory characteristics of the patients to reveal the
risk factors for cardiac manifestations. Patients were divided into two groups based
on the presence of antiphospholipid antibodies (APA); 258 (69.9%) patients were APA
positive, and 111 (30.1%) patients were APA negative. Mitral and tricuspid insufficiency,
aortic stenosis and pulmonary arterial hypertension were more common in APA-positive
patients. Anticardiolipin IgG showed the strongest correlation with any non-thrombotic
cardiac manifestations. Based on our results, the adjusted global antiphospholipid
syndrome score (aGAPSS) above 8.5 is predictive of valvulopathies and ischemic heart
disease, while aGAPSS above 9.5 is predictive of cardiomyopathies. The presence of
antiphospholipid antibodies may affect the development of cardiac manifestations in
SLE. Periodic cardiological and echocardiographic screening of patients without cardiac
complaints, as well as regular monitoring of antiphospholipid antibodies, have great
importance during the treatment of SLE patients.
