Lupus & antiphospholipid syndrome
Cardiac involvement in the catastrophic antiphospholipid syndrome (CAPS): Lessons from the “CAPS registry”
Authors' conclusion
Cardiac involvement is frequent in CAPS, with association with kidney involvement, and it is not related to higher mortality.
Study context
- Population
- Patients with CAPS in the CAPS Registry778 CAPS events
- Participants
- 749 patients
- Exposure
- CAPS events with vs without cardiac involvement
- Cardiac involvementn = 404
- Outcome
- Cardiac involvement and the factors associated with it
Methodological detailsinternational registry (CAPS Registry), univariate and multivariate analysis
- International registry (CAPS Registry)
- Univariate and multivariate analysis
Main finding
As reported in the abstract
Cardiac involvement
Cardiac involvement
52 %
404
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Clinical features during CAPS events with vs without heart involvementCardiac involvement vs No cardiac involvement | Stroke 29% vs. 21 % | P = 0.012 |
| Clinical features during CAPS events with vs without heart involvementCardiac involvement vs No cardiac involvement | Transient cerebral vascular accident 2% vs. 1 % | P = 0.005 |
| Clinical features during CAPS events with vs without heart involvementCardiac involvement vs No cardiac involvement | Pulmonary infarction 26% vs. 3 % | P = 0.017 |
| Clinical features during CAPS events with vs without heart involvementCardiac involvement vs No cardiac involvement | Renal infarction 46% vs. 35 % | P = 0.006 |
| Clinical features during CAPS events with vs without heart involvementCardiac involvement vs No cardiac involvement | Acute kidney injury 70% vs. 53 % | P < 0.001 |
| Clinical features during CAPS events with vs without heart involvementCardiac involvement vs No cardiac involvement | Livedo reticularis 24% vs. 17 % | P = 0.016 |
| Acute kidney injury independently associated with cardiac involvement (multivariate)Only clinical characteristic independently associated | OR 1.068 (95 % CI 1.8–4.8) | P < 0.001 |
Main cardiac manifestations
- Heart failure
- 185/377 (55 %)
- Valve disease
- 116/377 (31 %)
- Acute MI
- 104/378 (28 %)
Cardiac thrombotic microangiopathy in patients with autopsy/biopsy
- Cardiac thrombotic microangiopathy, of 58 with autopsy/biopsy
- 48 (83 %)
Mortality
- Cardiac involvement was not related to higher mortality
Original publication
Cardiac involvement in the catastrophic antiphospholipid syndrome (CAPS): Lessons from the “CAPS registry”. Semin Arthritis Rheum. Published 26 March 2024. doi:10.
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