Newer antiphospholipid antibodies predict adverse outcomes in patients with acute coronary syndrome

Thomas P. Greco, Ann Marie Conti-Kelly, Thomas Greco, Robin Doyle, Eiji Matsuura, J. Robert Anthony, Luis R. Lopez

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)613-620
Number of pages8
JournalAmerican Journal of Clinical Pathology
Volume132
Issue number4
DOIs
Publication statusPublished - Oct 1 2009

Keywords

  • Anti-β-glycoprotein i
  • Antiphospholipid antibodies
  • Coronary artery disease
  • Oxidized low-density lipoprotein

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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