Increased titres of anti-human heat shock protein 60 predict an adverse one year prognosis in patients with acute cardiac chest pain.
OBJECTIVE
To assess whether antibodies to human heat shock protein 60 (anti-huhsp60) or to mycobacterial heat shock protein 65 (anti-mhsp65) predict an adverse one year prognosis in patients admitted with acute cardiac chest pain.


METHODS
Prospective observational study.


METHODS
Teaching hospital.


METHODS
588 consecutive emergency admissions of patients with acute chest pain of suspected cardiac origin.


METHODS
Anti-huhsp60 and anti-mhsp65 titres were assayed on samples drawn on the morning after admission. The end points after discharge were coronary heart disease death, non-fatal myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, angiogram, or readmission with further cardiac ischaemic chest pain.


RESULTS
During follow up after discharge (mean of 304 days, range 1-788 days), 277 patients had at least one of the study outcomes. Patients with increased titres of anti-huhsp60 had an adverse prognosis (hazard ratio 1.56 (95% confidence interval 1.09 to 2.23) comparing highest versus lowest quartiles, p = 0.015). Anti-mhsp65 titres were not predictive.


CONCLUSIONS
Patients admitted with acute cardiac chest pain and increased titres of anti-huhsp60 had an adverse one year prognosis.
Birnie
D H
DH
Department of Medical Cardiology, Royal Infirmary, Glasgow, UK. dbirnie@ottawaheart.ca
Vickers
L E
LE
Hillis
W S
WS
Norrie
J
J
Cobbe
S M
SM
D000208:Acute Disease; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis*; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D018834:Chaperonin 60 / Q000276:immunology*; D004562:Electrocardiography; D005260:Female; D006360:Heat-Shock Proteins / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome; D024101:Mitochondrial Proteins
D001323:Autoantibodies; D015415:Biomarkers; D018834:Chaperonin 60; D006360:Heat-Shock Proteins; C060293:HSPD1 protein, human; D024101:Mitochondrial Proteins