Lupus anticoagulant (LA) is the strongest biomarker predicting ASCVD in SLE patients, followed by anticardiolipin antibodies (aCL) and anti-β2 glycoprotein I antibodies (aβ2GPI), with IgG isotypes showing stronger associations than IgM. High-risk profiles, including double or triple aPLs positivity, significantly increase cardiovascular risk. Aspirin has a protective effect, reducing ASCVD risk in aPL-positive patients. These findings underscore the importance of targeted monitoring and prevention in high-risk SLE populations. This evidence concerns the gene ACLY and systemic lupus erythematosus.