TY - JOUR
T1 - Newer antiphospholipid antibodies predict adverse outcomes in patients with acute coronary syndrome
AU - Greco, Thomas P.
AU - Conti-Kelly, Ann Marie
AU - Greco, Thomas
AU - Doyle, Robin
AU - Matsuura, Eiji
AU - Anthony, J. Robert
AU - Lopez, Luis R.
PY - 2009/10
Y1 - 2009/10
N2 - Antiphospholipid antibodies (aPLs) have been implicated in atherogenesis. We studied 344 patients with acute coronary syndromes; approximately 40% were aPL+ in 1 or more tests and 60% aPL-. In 215 patients, coronary artery disease (CAD) was angiographically documented, with 43.7% positive for aPL vs 34.9% of patients without CAD positive for aPLs. Anti-β2-glycoprotein I (β2GPI; 54%) and antioxidized low-density lipoprotein (oxLDL)/β2GPI (48%) were most frequent, accounting for 87% of all aPL+ CAD cases. aPLs correlated with severity of CAD (P = .012). Adverse events occurred in 16.7% of patients with CAD, more frequently in patients who were aPL+ (P = .0006; relative risk, 2.9; 95% confidence interval, 1.5-5.6). Patients who were aPL+ with severe CAD had more adverse events than patients who were aPL- with severe CAD (P = .005) and aPL+ patients undergoing revascularization procedures (P = .001). Vascular events occurred in 21.7% of aPL+ patients compared with 7.1% of aPL- patients (P = .005). Anti-β2GPI and anti-oxLDL/β2GPI were associated with CAD severity and adverse outcomes.
AB - Antiphospholipid antibodies (aPLs) have been implicated in atherogenesis. We studied 344 patients with acute coronary syndromes; approximately 40% were aPL+ in 1 or more tests and 60% aPL-. In 215 patients, coronary artery disease (CAD) was angiographically documented, with 43.7% positive for aPL vs 34.9% of patients without CAD positive for aPLs. Anti-β2-glycoprotein I (β2GPI; 54%) and antioxidized low-density lipoprotein (oxLDL)/β2GPI (48%) were most frequent, accounting for 87% of all aPL+ CAD cases. aPLs correlated with severity of CAD (P = .012). Adverse events occurred in 16.7% of patients with CAD, more frequently in patients who were aPL+ (P = .0006; relative risk, 2.9; 95% confidence interval, 1.5-5.6). Patients who were aPL+ with severe CAD had more adverse events than patients who were aPL- with severe CAD (P = .005) and aPL+ patients undergoing revascularization procedures (P = .001). Vascular events occurred in 21.7% of aPL+ patients compared with 7.1% of aPL- patients (P = .005). Anti-β2GPI and anti-oxLDL/β2GPI were associated with CAD severity and adverse outcomes.
KW - Anti-β-glycoprotein i
KW - Antiphospholipid antibodies
KW - Coronary artery disease
KW - Oxidized low-density lipoprotein
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U2 - 10.1309/AJCP2FJUT2YZGITK
DO - 10.1309/AJCP2FJUT2YZGITK
M3 - Article
C2 - 19762540
AN - SCOPUS:70349582320
SN - 0002-9173
VL - 132
SP - 613
EP - 620
JO - American Journal of Clinical Pathology
JF - American Journal of Clinical Pathology
IS - 4
ER -