Antiphospholipid antibodies in patients with coronary artery disease: new cardiac risk factors?

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Published on: January 28, 2020

Tom P Greco1, Ann Marie Conti-Kelly, Eiji Matsuura

  • 1Saint Mary's Hospital, Department of Medicine, Waterbury, Connecticut 06706, USA. tgreco@stmh.org

Annals of the New York Academy of Sciences
|September 26, 2007
PubMed

Insights

Antiphospholipid antibodies (aPL) are linked to coronary artery disease (CAD). This study found aPL presence associated with more severe CAD, increased adverse cardiac events, and higher risk of thrombotic events in patients with chest pain.

Area of Science:

  • Cardiovascular Medicine
  • Immunology
  • Thrombosis Research

Background:

  • Antiphospholipid antibodies (aPL) are implicated in the development of coronary artery disease (CAD).
  • The association between aPL and CAD severity, patient outcomes, and risk factors requires further investigation.

Purpose of the Study:

  • To evaluate the presence of aPL in patients presenting with chest pain or acute coronary syndromes (ACS).
  • To determine if aPL are associated with the presence and severity of CAD, adverse cardiac outcomes, and extracardiac thrombotic events.

Main Methods:

  • A cohort of 232 patients with chest pain/ACS were assessed for aPL prior to diagnostic and therapeutic interventions.
  • Coronary angiograms were graded for CAD severity, and patients were followed for adverse outcomes and risk factors.
  • Specific aPL, including anti-beta2 glycoprotein-1 (aβ2GP1) and anticardiolipin antibodies (aCL), and their isotypes were analyzed.

Main Results:

  • 37% of patients were positive for one or more aPL, with a higher prevalence in women.
  • aPL presence was associated with both the presence and severity of CAD.
  • aPL positivity significantly correlated with increased adverse cardiac outcomes (P=0.045) and extracardiac thrombotic events (P=0.033).
  • Anti-beta2 glycoprotein-1 (aβ2GP1) was the most common aPL, and IgM was the predominant isotype.
  • Family history of antiphospholipid syndrome (APS)-related events was more frequent in aPL-positive individuals (P=0.027).

Conclusions:

  • Antiphospholipid antibodies are associated with coronary artery disease and adverse cardiovascular outcomes in patients with chest pain/ACS.
  • The findings suggest aPL may play a role in the pathogenesis and prognosis of CAD.
  • Further research into aPL screening in patients with CAD is warranted.

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