alexa Head-to-Head Comparison of Auto-Antibodies for Cardiovascular Outcome Prediction after Myocardial Infarction: a Prospective Study | OMICS International | Abstract
ISSN: 2155-9880

Journal of Clinical & Experimental Cardiology
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Research Article

Head-to-Head Comparison of Auto-Antibodies for Cardiovascular Outcome Prediction after Myocardial Infarction: a Prospective Study

Nicolas Vuilleumier1*, Sabrina Pagano1, Kenza Lahlou1, Poncet Antoine2, Emmanuel Charbonney3, Gary L. Norman4, Francois Mach5 and Pascale Roux-Lombard1,6
1Division of Laboratory Medicine Service, Department of Genetics and Laboratory Medicine, Geneva University Hospitals and University of Geneva, Switzerland
2Division of Clinical Epidemiology, Geneva University Hospitals, Geneva, Switzerland
3Keenan Research Centre, St. Michael’s Hospital, Toronto, Canada
4INOVA Diagnostics, Inc., San Diego, CA, USA
5Division of Cardiology, Department of Internal Medicine, Geneva University Hospitals and University of Geneva, Switzerland
6Division of Immunology and Allergy, Department of Internal Medicine, Geneva University Hospitals and University of Geneva, Switzerland
Corresponding Author : Dr. Nicolas Vuilleumier
Division of Laboratory Medicine
Department of Genetics and Laboratory Medicine
Geneva University Hospitals, 4 rue Gabrielle Perret-Gentil
1211 Geneva, Switzerland
Tel: +41.22.372.91.50
Fax: +41.22.372.73.99
E-mail: [email protected]
Received November 02, 2011; Accepted December 15, 2011; Published December 19, 2011
Citation: Vuilleumier N, Pagano S, Lahlou K, Poncet A, Charbonney E, et al. (2011) Head-to-Head Comparison of Auto-Antibodies for Cardiovascular Outcome Prediction after Myocardial Infarction: a Prospective Study. J Clinic Experiment Cardiol 2:169. doi:10.4172/2155-9880.1000169
Copyright: © 2011 Vuilleumier N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Background:Atherosclerosis-related inflammation fulfils the three required Koch’s postulates to be considered as an autoimmune disease. Accordingly, several auto-antibodies have been associated with an increased cardiovascular (CV) risk suggesting that they could be of help for cardiovascular risk stratification in the future.

Aims:to compare the prognostic accuracies of auto-antibodies to β2 glycoprotein I (anti-β2GPI) domain I and IV, cardiolipin, apolipoproteinA-1 (anti-apoA-1 IgG), heat-shock protein 60 (anti-HSP-60), and to phosphorylcholine (anti-PC IgM) for 12-months major cardiovascular events (MACE) prediction after myocardial infarction (MI).

Methods:Auto-antibodies were prospectively assessed by ELISA in 221 MI patients without autoimmune diseases who all completed the 12-months follow-up. Prognostic accuracies were evaluated by receiving operating characteristic (ROC) curve analyses, and risk analyses were performed using Cox regression model.

Results:MACE rate was 14% during follow-up. Among the tested auto-antibodies, anti-apoA-1 IgG antibodies were found to be the only candidate significantly predicting subsequent MACE ((Area Under the Curve (AUC):0.65; p=0.007)). A non-significant trend was observed for anti-cardiolipin (AUC: 0.59; p=0.05) and anti-HSP-60 (AUC:0.58; p=0.06) antibodies. No association was retrieved for others auto-antibodies. Cox regression analyses indicated that anti-apoA-1 IgG positivity was associated to a 4-fold MACE risk increase, independently of the 10-year global Framingham risk-score (Hazard Ratio: 3.8; p=0.002)

Conclusions:In this head-to-head prospective comparison study performed on secondary prevention patients anti-apoA-1 IgG appeared as the candidate with the strongest and independent MACE prognostic accuracy in non-autoimmune settings.

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