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Antiphospholipid antibodies in acute coronary syndrome

Intensive Care Unit, 3rd Department of Internal Medicine, University of Debrecen Medical Center, Debrecen, Hungary

G Lakos

Regional Immunological Laboratory, 3rd Department of Internal Medicine, University of Debrecen Medical Center, Debrecen, Hungary

A Kerényi

Department of Clinical Biochemistry and Molecular Pathology, University of Debrecen Medical Center, Debrecen, Hungary

Z Szekanecz

Division of Rheumatology, 3rd Department of Internal Medicine, University of Debrecen Medical Center, Debrecen, Hungary

G Szegedi

Divisions of Clinical Immunology, 3rd Department of Internal Medicine, University of Debrecen Medical Center, Debrecen, Hungary

Y Shoenfeld

Department of Medicine "B", Chaim Sheba Medical Center, Tel-Hashomer, and the Sacker faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

P Soltész

Intensive Care Unit, 3rd Department of Internal Medicine, University of Debrecen Medical Center, Debrecen, Hungary, soltesz{at}iiibel.dote.hu

Antiphospholipid (aPL) antibodies entailing anticardiolipin (aCL) and anti-ß₂ glycoprotein I (anti-ß₂ GPI) antibodies may be involved in a number of vascular diseases including coronary artery diseases (CAD) or stroke. Here we assessed the presence of aPL antibodies in acute coronary syndrome (ACS). The frequency of anti-ß₂ GPI antibodies was significantly higher (14.4%) in ACS in comparison to control healthy subjects (2%). In addition, serum concentrations of anti-ß₂ GPI antibodies were also increased in ACS. Anti-ß₂ GPI antibodies of the IgA isotype might be the most relevant for the onset and outcome of ACS. Regarding subclasses of ACS, anti-ß₂ GPI IgA antibodies were elevated in unstable angina (UA) and myocardial infarction with ST elevation (STEMI), but not in myocardial infarction without ST elevation (NSTEMI). The involvement of anti-ß₂ GPI antibodies in ACS was more pronounced in men than women, and in younger rather than older patients. Finally, anti-ß₂ GPI antibodies in ACS were associated with previous stroke, but not with hypertension or previous myocardial infarction. Thus, anti-ß₂ GPI antibodies may be involved in the thrombotic events underlying ACS.

Key Words: acute coronary syndrome • antiphospholipid antibody • ß2 glycoprotein I • coronary artery disease • myocardial infarction

Lupus, Vol. 13, No. 6, 423-427 (2004)
DOI: 10.1191/0961203304lu1011oa


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