title: Long-term prognostic value of IgM antibodies against phosphorylcholine for adverse cardiovascular events in patients with stable coronary heart disease.
abstract: BACKGROUND
  Low concentrations of IgM-phosphorylcholine autoantibodies (IgM-anti-PC) have been shown to be associated with increased risk of incident cardiovascular disease (CVD) events and total mortality in patients suffering from an acute coronary syndrome. We assessed whether IgM-anti-PC concentrations add prognostic information for cardiovascular risk in patients with known stable coronary artery disease (CAD).
  
  
  METHODS
  IgM-anti-PC concentrations were measured in serum obtained from 1062 patients with clinically manifest stable CAD at baseline. The relation of IgM-anti PC concentrations with CVD events during long-term follow-up was assessed by the Kaplan-Meier and life table method and quantified by means of the log-rank test. Then, Cox proportional hazards regression analysis was performed to assess the independent association of IgM anti-PC concentration with risk of secondary CVD events after adjustment for established and emerging risk factors.
  
  
  RESULTS
  In n = 1062 patients with stable CAD only very low IgM anti-PC serum concentrations were associated with increased risk for future fatal and non-fatal coronary events (n = 201 during median of 10 years of follow-up). Among patients with IgM anti-PC concentrations in the lowest decile, the partly adjusted hazard ratio for fatal and non-fatal coronary events was 1.60 (95% confidence interval (CI) 1.01-2.55) compared to the top quartile and 1.94 (95%-CI 1.18-3.18) after adjustment for multiple covariates.
  
  
  CONCLUSIONS
  In patients with stable CAD, very low concentrations of IgM anti-PC are associated with increased risk for fatal and non-fatal future coronary events and thus may add prognostic information to traditional cardiovascular risk factors among these patients.
authors.affiliation: Dept. of Internal Medicine II - Cardiology, University of Ulm Medical Centre, Ulm, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Imhof
authors.affiliation: Dept. of Internal Medicine II - Cardiology, University of Ulm Medical Centre, Ulm, Germany; Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. Electronic address: koenig@dhm.mhn.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koenig
authors.affiliation: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Jaensch
authors.affiliation: Division of Clinical Epidemiology and Aging Research C070, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Mons
authors.affiliation: Division of Clinical Epidemiology and Aging Research C070, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
authors.affiliation: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Division of Clinical Epidemiology and Aging Research C070, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Rothenbacher
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis / Q000276:immunology* / Q000401:mortality; D015536:Down-Regulation; D005260:Female; D005858:Germany; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010767:Phosphorylcholine / Q000276:immunology*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012698:Serologic Tests
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D007075:Immunoglobulin M; D010767:Phosphorylcholine
keywords: Biomarkers; Cardiovascular disease; IgM anti-PC; Inflammation; Prognostic markers