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
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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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.