title: The prognostic value of autoantibodies against β1-adrenoceptor and cardiac troponin-I for clinical outcomes in STEMI.
abstract: OBJECTIVE
  The prevalence and potential role of autoantibodies against the β1-adrenoceptor autoantibody (β1-aab) and cardiac troponin-I (anti-cTnI) in patients with ST-elevation myocardial infarction (STEMI) are unknown. The aim of this study is to test whether β1-aab and anti-cTnI are prevalent in STEMI patients and to investigate their prognostic value for left ventricular remodeling and clinical outcomes in STEMI patients.
  
  
  METHODS
  This study included 491 patients with first STEMI at two centers. Serum samples were obtained. β1-aab and anti-cTnI were detected by enzyme-linked immunoabsorbent assay. Echocardiographic assessments were performed at admission and following 1 year. The major adverse cardiovascular events (MACEs) were evaluated during a median follow-up period of 37 months.
  
  
  RESULTS
  The positive rates of β1-aab and anti-cTnI in STEMI patients were 39.1 and 19.1%, respectively. The extent of left ventricular remodeling correlated with the presence of β1-aab and/or anti-cTnI (double positive > single positive > double negative). Logistic regression revealed that both β1-aab [odds ratio (OR) 2.298, 95% confidence interval (CI) 1.561-3.384, P < 0.001] and anti-cTnI (OR 2.389, 95% CI 1.460-3.909, P = 0.001) were predictive of left ventricular remodeling. Cox proportional-hazard regression revealed that β1-aab, but not anti-cTnI, was strongly predictive of MACEs (hazard ratio 1.802, 95% CI 1.301-2.496, P < 0.001).
  
  
  CONCLUSIONS
  β1-aab and anti-cTnI were prevalent in STEMI patients. Both β1-aab and anti-cTnI were independent predictors of left ventricular remodeling, whereas only β1-aab was an independent predictor of MACEs. Our findings suggest that β1-aab and anti-cTnI may actively participate in the process of left ventricular remodeling after STEMI.
authors.affiliation: Department of Cardiovascular Medicine, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, and Institute of Cardiovascular Channelopathy, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education, Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, Shaanxi, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Fan
authors.forename: Yuewu
authors.initials: Y
authors.lastname: Chen
authors.forename: Zhaofei
authors.initials: Z
authors.lastname: Wan
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
authors.forename: Aiqun
authors.initials: A
authors.lastname: Ma
mesh_terms: D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002681:China; D004562:Electrocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D018342:Receptors, Adrenergic, beta-1 / Q000276:immunology*; D000072657:ST Elevation Myocardial Infarction / Q000097:blood*; D013997:Time Factors; D019210:Troponin I / Q000276:immunology*; D020257:Ventricular Remodeling
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D018342:Receptors, Adrenergic, beta-1; D019210:Troponin I