title: IgA anticardiolipin antibody is associated with the extent of daily-life ischaemia in patients with chronic coronary artery disease.
abstract: BACKGROUND
  Circulating anticardiolipin antibodies (aCL) may cause endothelial dysfunction. We investigated whether aCL are related to platelet activation, thrombin generation and daily-life ischaemia in patients with chronic coronary artery disease (CAD).
  
  
  METHODS
  We measured (medians 25th-75th percentile) IgG, IgM, IgA aCL serum levels (Arbitrary Elisa Units, AEU), prothrombin fragments (F1+2, nmol/l), 24 h urine excretion of 11-dehydrothromboxane B2 (11-DHTXB2, ng/mg creatinine) creatine kinase (CK) and its cardiac isoenzyme CK-MB (IU/l) in 60 patients with angiographically documented CAD and in 40 age and sex matched controls. Patients underwent a 48 h Holter monitoring for assessment of the number and duration of ischaemic episodes.
  
  
  RESULTS
  Patients had higher IgA-aCL levels than controls (3.2 vs 2.4 AEU, p = 0.002). Increased IgA-ACA levels were related to increased number and duration of ischaemic episodes (p<0.01). By ANOVA, patients with >or=10 ischaemic episodes (3rd tertile) or duration of ischaemia >or=32min (3rd tertile) had higher IgA-aCL than those with lower ischaemic burden (4.95 vs 3 vs 2.5 AEU, p = 0.002 and 4.9 vs 3 vs 2.5 AEU, p = 0.001 respectively). Patients with >or=2 ischaemic episodes (2nd and 3rd tertile) had higher 11-DHTXB2, than those with minimal ischaemia (2< episodes, 1st tertile) (p = 0.001). CK and CK-MB were within normal range after Holter monitoring. Receiver operating curve analysis showed a greater area under the curve for IgA-aCL than for 11-DHTXB2 in predicting severe ischaemia (>or=10 ischemic episodes or >or=32 min duration of ischaemia).
  
  
  CONCLUSIONS
  Increasing IgA-aCL levels are associated with increasing ischemic burden in patients with CAD.
authors.affiliation: 2nd Cardiology Department, Attikon Hospital, University of Athens, Perikleous 19, N. Chalkidona, Athens, 14343, Greece. ignoik@otenet.gr
authors.forename: Ignatios
authors.initials: I
authors.lastname: Ikonomidis
authors.forename: John
authors.initials: J
authors.lastname: Lekakis
authors.forename: Georgia
authors.initials: G
authors.lastname: Vamvakou
authors.forename: Sozos
authors.initials: S
authors.lastname: Loizou
authors.forename: Ioanna
authors.initials: I
authors.lastname: Revela
authors.forename: Felicita
authors.initials: F
authors.lastname: Andreotti
authors.forename: Dimitrios T
authors.initials: DT
authors.lastname: Kremastinos
authors.forename: Petros
authors.initials: P
authors.lastname: Nihoyannopoulos
mesh_terms: D000368:Aged; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000097:blood; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*; D015539:Platelet Activation
chemical_list: D017153:Antibodies, Anticardiolipin; D015415:Biomarkers; D007070:Immunoglobulin A