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Newer antiphospholipid antibodies predict adverse outcomes in patients with acute coronary syndrome

Thomas P Greco1, Ann Marie Conti-Kelly, Thomas Greco

  • 1Departments of Medicine, Saint Mary's Hospital, Waterbury, CT 06706, USA.

American Journal of Clinical Pathology
|September 19, 2009
PubMed

Insights

Antiphospholipid antibodies (aPLs) are linked to severe coronary artery disease (CAD). Patients with aPLs experienced more adverse cardiovascular events and vascular issues, highlighting aPLs as a risk factor in CAD patients.

Area of Science:

  • Cardiovascular Medicine
  • Immunology
  • Atherosclerosis Research

Background:

  • Antiphospholipid antibodies (aPLs) are increasingly recognized for their role in atherogenesis.
  • Previous studies suggest aPLs may contribute to the development and progression of cardiovascular diseases.

Purpose of the Study:

  • To investigate the association between antiphospholipid antibodies and the presence, severity, and outcomes of coronary artery disease (CAD) in patients with acute coronary syndromes.
  • To identify specific aPLs associated with CAD and adverse cardiovascular events.

Main Methods:

  • Cross-sectional study of 344 patients with acute coronary syndromes.
  • Coronary artery disease (CAD) was assessed angiographically in 215 patients.
  • Prevalence and types of aPLs were determined, including anti-beta(2)-glycoprotein I (beta2GPI) and anti-oxidized low-density lipoprotein (oxLDL)/beta2GPI.
  • Correlation analysis was performed between aPL status, CAD severity, and adverse clinical outcomes.

Main Results:

  • Approximately 40% of patients with acute coronary syndromes were positive for aPLs.
  • aPL positivity was higher in patients with angiographically documented CAD (43.7%) compared to those without CAD (34.9%).
  • Anti-beta2GPI and anti-oxLDL/beta2GPI were the most prevalent aPLs, accounting for 87% of aPL-positive CAD cases.
  • aPLs correlated significantly with CAD severity (P = .012).
  • Patients with aPLs experienced higher rates of adverse events (16.7% vs. 8.1%, P = .0006) and vascular events (21.7% vs. 7.1%, P = .005) compared to aPL-negative patients.
  • Severe CAD patients who were aPL-positive had more adverse events than aPL-negative counterparts (P = .005).

Conclusions:

  • Antiphospholipid antibodies are significantly associated with the presence and severity of coronary artery disease.
  • Specific aPLs, particularly anti-beta2GPI and anti-oxLDL/beta2GPI, are linked to worse outcomes in CAD patients.
  • aPL positivity represents a risk factor for adverse cardiovascular events in patients with acute coronary syndromes.

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