title: Association of autoantibodies to heat-shock protein 60 with arterial vascular events in patients with antiphospholipid antibodies.
abstract: OBJECTIVE
  Anti-heat shock protein 60 autoantibodies (anti-Hsp60) are associated with cardiovascular disease and are known to affect endothelial cells in vitro, and we have recently shown that anti-Hsp60 promote thrombosis in a murine model of arterial injury. Based on those findings, we undertook the present study to investigate the hypothesis that the presence of anti-Hsp60, alone or in combination with other thrombogenic risk factors, is associated with an elevated risk of vascular events.
  
  
  METHODS
  The study population was derived from 3 ongoing cohort studies: 2 independent systemic lupus erythematosus (SLE) registries and 1 cohort comprising SLE patients and non-SLE patients. Data from a total of 402 participants were captured; 199 of these participants had had confirmed vascular events (arterial vascular events in 102, venous vascular events in 76, and both arterial and venous vascular events in 21). Anti-Hsp60 were detected by enzyme-linked immunoassay, and association with vascular events was assessed by regression analysis.
  
  
  RESULTS
  Multiple regression analysis revealed that arterial vascular events were associated with male sex, age, and hypertension. Analyses of the vascular events according to their origin showed an association of anti-Hsp60 with arterial vascular events (odds ratio 2.26 [95% confidence interval 1.13-4.52]), but not with venous vascular events. Anti-Hsp60 increased the risk of arterial vascular events (odds ratio 5.54 [95% confidence interval 1.89-16.25]) in antiphospholipid antibody (aPL)-positive, but not aPL-negative, individuals.
  
  
  CONCLUSIONS
  We demonstrate that anti-Hsp60 are associated with an increased risk of arterial vascular events, but not venous vascular events, in aPL-positive individuals. These data suggest that anti-Hsp60 may serve as a useful biomarker to distinguish risk of arterial and venous vascular events in patients with aPL.
authors.affiliation: McGill University Health Centre, Montreal, Quebec, Canada. melanie.dieude@umontreal.ca
authors.forename: Mélanie
authors.initials: M
authors.lastname: Dieudé
authors.forename: José A
authors.initials: JA
authors.lastname: Correa
authors.forename: Carolyn
authors.initials: C
authors.lastname: Neville
authors.forename: Christian
authors.initials: C
authors.lastname: Pineau
authors.forename: Jerrold S
authors.initials: JS
authors.lastname: Levine
authors.forename: Rebecca
authors.initials: R
authors.lastname: Subang
authors.forename: Carolina
authors.initials: C
authors.lastname: Landolt-Marticorena
authors.forename: Jiandong
authors.initials: J
authors.lastname: Su
authors.forename: Jeannine
authors.initials: J
authors.lastname: Kassis
authors.forename: Susan
authors.initials: S
authors.lastname: Solymoss
authors.forename: Paul R
authors.initials: PR
authors.lastname: Fortin
authors.forename: Joyce
authors.initials: J
authors.lastname: Rauch
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000276:immunology* / Q000378:metabolism; D001323:Autoantibodies / Q000276:immunology* / Q000378:metabolism; D018834:Chaperonin 60 / Q000276:immunology* / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000276:immunology / Q000378:metabolism; D008180:Lupus Erythematosus, Systemic / Q000276:immunology / Q000378:metabolism; D008297:Male; D012307:Risk Factors; D014652:Vascular Diseases / Q000276:immunology* / Q000378:metabolism
chemical_list: D017152:Antibodies, Antiphospholipid; D001323:Autoantibodies; D018834:Chaperonin 60