title: Mannose-binding lectin as a risk factor for acute coronary syndromes.
abstract: BACKGROUND
  Mannose-binding lectin (MBL) is a multifunctional protein involved in innate immunity. We tested whether MBL and elevated viral and bacterial antibodies were risk factors for acute coronary events.
  
  
  METHODS
  Controlled cohort study.
  
  
  METHODS
  A total of 354 patients with unstable angina pectoris (UA) or acute myocardial infarction (AMI) were compared with 334 paired controls.
  
  
  RESULTS
  Enterovirus titres were associated with increased risk of UA (odds ratio 10.04, P<0.001) and AMI (odds ratio 3.18, P=0.003), but titres did not correlate with either MBL concentration or genotype. Chlamydia pneumoniae heat shock protein 60 IgG concentrations were also associated with increased risk of UA (odds ratio 1.63, P=0.049). Compared to asymptomatic controls, patients had lower complement C3 serum concentrations (P<0.001), higher MBL serum concentration, and more frequently had MBL genotypes that determined high MBL levels (P<0.001). High MBL genotypes had odds ratios of 1.16 (P=0.010) for UA and 1.12 (P=0.007) for AMI. The elevation of MBL concentrations in the acute phase correlated with MBL concentrations after recovery (r=0.85, P<0.001).
  
  
  CONCLUSIONS
  Elevated microbial titres, indicating an on-going inflammation, were associated with cardiovascular events. MBL might have a dual role both decreasing susceptibility to infections and increasing the risk of acute coronary syndromes.
authors.affiliation: Department of Pediatric Cardiology, University Hospital of Lund, Sweden. erkki.pesonen@skane.se
authors.forename: Erkki
authors.initials: E
authors.lastname: Pesonen
authors.forename: Mikko
authors.initials: M
authors.lastname: Hallman
authors.forename: Seppo
authors.initials: S
authors.lastname: Sarna
authors.forename: Eva
authors.initials: E
authors.lastname: Andsberg
authors.forename: Ritva
authors.initials: R
authors.lastname: Haataja
authors.forename: Seppo
authors.initials: S
authors.lastname: Meri
authors.forename: Kenneth
authors.initials: K
authors.lastname: Persson
authors.forename: Mirja
authors.initials: M
authors.lastname: Puolakkainen
authors.forename: Hans
authors.initials: H
authors.lastname: Ohlin
authors.forename: Lennart
authors.initials: L
authors.lastname: Truedsson
mesh_terms: D000789:Angina, Unstable / Q000209:etiology* / Q000235:genetics / Q000382:microbiology; D000907:Antibodies, Bacterial / Q000032:analysis; D000914:Antibodies, Viral / Q000032:analysis; D016022:Case-Control Studies; D018834:Chaperonin 60 / Q000276:immunology; D016993:Chlamydophila pneumoniae / Q000276:immunology; D015331:Cohort Studies; D003176:Complement C3 / Q000378:metabolism; D004770:Enterovirus / Q000276:immunology; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000382:microbiology; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood* / Q000235:genetics; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000235:genetics / Q000382:microbiology; D012307:Risk Factors
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D018834:Chaperonin 60; D003176:Complement C3; D037601:Mannose-Binding Lectin