title: Newer antiphospholipid antibodies predict adverse outcomes in patients with acute coronary syndrome.
abstract: Antiphospholipid antibodies (aPLs) have been implicated in atherogenesis. We studied 344 patients with acute coronary syndromes; approximately 40% were aPL+ in 1 or more tests and 60% aPL-. In 215 patients, coronary artery disease (CAD) was angiographically documented, with 43.7% positive for aPL vs 34.9% of patients without CAD positive for aPLs. Anti-beta(2)-glycoprotein I (beta2GPI; 54%) and anti-oxidized low-density lipoprotein (oxLDL)/beta2GPI (48%) were most frequent, accounting for 87% of all aPL+ CAD cases. aPLs correlated with severity of CAD (P = .012). Adverse events occurred in 16.7% of patients with CAD, more frequently in patients who were aPL+ (P = .0006; relative risk, 2.9; 95% confidence interval, 1.5-5.6). Patients who were aPL+ with severe CAD had more adverse events than patients who were aPL- with severe CAD (P = .005) and aPL+ patients undergoing revascularization procedures (P = .001). Vascular events occurred in 21.7% of aPL+ patients compared with 7.1% of aPL- patients (P = .005). Anti-beta2GPI and anti-oxLDL/beta2GPI were associated with CAD severity and adverse outcomes.
authors.affiliation: Departments of Medicine, Saint Mary's Hospital, Waterbury, CT 06706, USA.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Greco
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Conti-Kelly
authors.forename: Thomas
authors.initials: T
authors.lastname: Greco
authors.forename: Robin
authors.initials: R
authors.lastname: Doyle
authors.forename: Eiji
authors.initials: E
authors.lastname: Matsuura
authors.forename: J Robert
authors.initials: JR
authors.lastname: Anthony
authors.forename: Luis R
authors.initials: LR
authors.lastname: Lopez
mesh_terms: D054058:Acute Coronary Syndrome / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000276:immunology; D003324:Coronary Artery Disease / Q000276:immunology*; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome; D053482:beta 2-Glycoprotein I / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid; D008077:Lipoproteins, LDL; D053482:beta 2-Glycoprotein I; C099252:oxidized low density lipoprotein