Antiphospholipid antibodies in patients with coronary artery disease: New cardiac risk factors?

Tom P. Greco, Ann Marie Conti-Kelly, Eiji Matsuura, Tom Greco, Ken J. Dier, Gregory Svanas, Robin Doyle, Luis R. Lopez

    Research output: Chapter in Book/Report/Conference proceedingConference contribution

    12 Citations (Scopus)

    Abstract

    Antiphospholipid antibodies (aPL) have been implicated in the pathogenesis of coronary artery disease (CAD). We evaluated the presence of aPL in patients with chest pain/acute coronary syndromes (ACS) to determine if aPL were associated with the presence and severity of CAD, adverse outcomes, and other coronary risk factors. Patients with chest pain/ACS were evaluated for aPL prior to diagnostic and therapeutic investigations. Coronary angiograms were graded according to the severity of disease. Risk factors, including family histories, were assessed and patients were followed for adverse outcomes. To date, 232 patients (116 M, 116 F, mean age 63 years) with a mean follow-up of 9 months were studied. Thirty-seven percent (86/232) were positive for one or more aPL. More women, 49/86 (57%), were aPL positive versus men, 37/86 (43%). The presence of aPL appeared associated with both presence and severity of CAD(P = 0.176 women; P = 0.163 men). In patients undergoing procedures (angioplasty, stent, bypass), aPL was significantly associated with both an increase in adverse cardiac outcomes (P = 0.045) and extracardiac thrombotic events (P = 0.033). Anti-β2 glycoprotein-1 (aβ2GP1) was the most frequent aPL, occurring in 68.5% of aPL-positive patients with CAD. Anticardiolipin antibody (aCL) occurred in only 7.4%. IgM isotypes were the most frequent for all categories of aPL (range 55-90%). Family history of antiphospholipid syndrome (APS)-related events was more significant in aPL-positive than aPL-negative individuals (P = 0.027).

    Original languageEnglish
    Title of host publicationAutoimmunity, Part D
    Subtitle of host publicationAutoimmune Disease, Annus Mirabilis
    PublisherBlackwell Publishing Inc.
    Pages466-474
    Number of pages9
    ISBN (Print)157331708X, 9781573317085
    DOIs
    Publication statusPublished - Jun 2007

    Publication series

    NameAnnals of the New York Academy of Sciences
    Volume1108
    ISSN (Print)0077-8923
    ISSN (Electronic)1749-6632

    Keywords

    • Acute coronary syndromes
    • Antiphospholipid syndrome
    • Cardiac risk
    • β2GP1 antibodies

    ASJC Scopus subject areas

    • Neuroscience(all)
    • Biochemistry, Genetics and Molecular Biology(all)
    • History and Philosophy of Science

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