Clinical characteristics and long-term outcomes of Libman-Sacks endocarditis in patients with systemic lupus erythematosus

OBJECTIVE: Treatment of Libman-Sacks (LS) endocarditis in patients with systemic lupus erythematosus (SLE) is challenging due to the lack of data. This study aimed to identify the clinical characteristics of SLE patients and LS endocarditis, and to investigate the treatment and prognosis of LS endocarditis.

METHODS: Of all the patients with SLE who underwent echocardiography between 2010 and 2019, 11 and 29 patients with and without LS endocarditis, respectively, were included. We compared the inflammatory and thrombotic profiles between patients with and without LS endocarditis, and investigated the treatment and long-term outcome of LS endocarditis.

RESULTS: No significant differences were observed in disease activity, clinical characteristics and inflammatory marker levels between patients with and without LS endocarditis. Patients with LS endocarditis had a significantly higher prevalence of antiphospholipid antibody (aPL) but a lower prevalence of SLE-specific antibody. Triple positivity of aPL was found in 72.7% and 13.8% of patients with and without LS endocarditis, respectively. Of 11 patients with LS endocarditis, six patients received anticoagulation therapy, and five patients received augmented immunosuppressive therapies. One patient who did not receive anticoagulation therapy developed cerebral infarction. Nine (82%) patients with LS endocarditis were classified as having antiphospholipid syndrome (APS). Despite the residual vegetation and valve dysfunction, surgical intervention was not required during the follow-up period of 56.8 months.

CONCLUSION: A significant correlation was observed between APS and LS endocarditis. Anticoagulation therapy should be considered to prevent thromboembolic complications in SLE patients with LS endocarditis.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:29

Enthalten in:

Lupus - 29(2020), 9 vom: 03. Aug., Seite 1115-1120

Sprache:

Englisch

Beteiligte Personen:

Yoo, Byung-Woo [VerfasserIn]
Lee, Sang-Won [VerfasserIn]
Song, Jason Jungsik [VerfasserIn]
Park, Yong-Beom [VerfasserIn]
Jung, Seung Min [VerfasserIn]

Links:

Volltext

Themen:

Antibodies, Antiphospholipid
Anticoagulants
Anticoagulation
Antiphospholipid syndrome
Immunosuppressive Agents
Journal Article
Libman–Sacks endocarditis
Non-bacterial endocarditis
Systemic lupus erythematosus

Anmerkungen:

Date Completed 04.05.2021

Date Revised 04.05.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1177/0961203320930097

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM311154344