Evidence map›Paper›PMID 40824342›Full record

ArticleClinical rheumatology2025

The distinct subtypes and prognosis of acute myocardial infarction in antiphospholipid syndrome patients.

Can Huang, Yuan Zhao, Hui Jiang, Yangzhong Zhou, Chaojun Hu, Xiaoxiao Guo, Mengtao Li, Xiaofeng Zeng, Jiuliang Zhao

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Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Can Huang *Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Yuan Zhao *Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Hui JiangDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Yangzhong ZhouDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Chaojun HuDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Xiaoxiao GuoDepartment of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Mengtao LiDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Xiaofeng ZengDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Jiuliang ZhaoDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. zjlpumc@sina.com.ORCID http://orcid.org/0000-0001-9308-2858

Funding

Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS) 2021-I2M-1-005National High Level hospital Clinical Research Funding 2022-PUMCH-B-013The Chinese National Key Technology R&D Program, Ministry of Science and Technology 2023YFC2507204
6 · The paper itself

Abstract

introductionAcute myocardial infarction (AMI) can be divided into myocardial infarction with coronary artery disease (MICAD) or with nonobstructive coronary arteries (MINOCA) according to the severity of artery stenosis. Antiphospholipid syndrome (APS) can present with AMI, but the subtype and prognosis are not fully understood.

methodsThe study was conducted based on the APS cohort in Peking Union Medical College Hospital. According to coronary angiography, AMI patients were classified as MICAD or MINOCA. Thrombotic APS (tAPS) patients were enrolled to explore the risk factors of AMI.

resultsThe study enrolled 36 APS-AMI patients, 26 (72%) patients with MICAD and 10 (28%) with MINOCA. 345 tAPS patients without coronary artery disease in APS cohort were selected as a control group. The risk factors of AMI were male, smoking history, anti-cardiolipin antibody (aCL), and anti-β2 glycoprotein I antibody (aβ2GPI). Secondary APS and aCL were more common in MINOCA (70% VS. 23.1%, P = 0.018; 100% (10/10) VS. 65.4%, P = 0.039), while previous atherosclerotic cardiovascular disease was less common in MINOCA (0 VS. 50%, P = 0.006). MINOCA patients tended to receive immunosuppression and anticoagulation therapy, while 57.7% MICAD patients received revascularization. In total, 13 (36.1%) patients experienced AMI recurrence during a mean follow-up of 42.25 months, which only occurred in the MICAD group. Over 60% (8/13) had recurrence more than once. Hydroxychloroquine was found to be a possible protective factor for AMI recurrence (HR 0.106, P = 0.032).

conclusionMale, smoking history, aCL, and aβ2GPI can be risk factors for AMI in APS patients. APS-MINOCA group had a significantly better prognosis. Hydroxychloroquine might prevent AMI recurrence. Key Points • Acute myocardial infarction (AMI) patients with antiphospholipid syndrome (APS) were younger than typical AMI patients, and 45% were women. • The subtype, myocardial infarction with non-obstructive coronary arteries (MINOCA) and myocardial infarction with coronary artery disease (MICAD), and prognosis of AMI in APS patients remains unknown. • MINOCA was associated with secondary APS and aCL, while MICAD with previous ASCVD. • MINOCA had a significantly better prognosis. Hydroxychloroquine might prevent AMI relapse.

Indexed as

Antiphospholipid SyndromeCoronary Artery DiseaseMyocardial InfarctionAdultAgedAntibodies, AnticardiolipinAntibodies, AntiphospholipidCoronary AngiographyFemaleHumansMaleMiddle AgedPrognosisRisk FactorsAntibodies, AnticardiolipinAntibodies, AntiphospholipidAcute myocardial infarction (AMI)Antiphospholipid syndrome (APS)Myocardial infarction with coronary artery disease (MICAD)Myocardial infarction with non-obstructive coronary arteries (MINOCA)

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.