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Abstract
Objective: To assess whether antibodies to human heat shock protein 60 (anti-huhsp60) or to mycobacterial heat shock protein 65 (anti-mhsp65) predict an adverse one year prognosis in patients admitted with acute cardiac chest pain.
Design: Prospective observational study.
Setting: Teaching hospital.
Patients: 588 consecutive emergency admissions of patients with acute chest pain of suspected cardiac origin.
Main outcome measures: Anti-huhsp60 and anti-mhsp65 titres were assayed on samples drawn on the morning after admission. The end points after discharge were coronary heart disease death, non-fatal myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, angiogram, or readmission with further cardiac ischaemic chest pain.
Results: During follow up after discharge (mean of 304 days, range 1–788 days), 277 patients had at least one of the study outcomes. Patients with increased titres of anti-huhsp60 had an adverse prognosis (hazard ratio 1.56 (95% confidence interval 1.09 to 2.23) comparing highest versus lowest quartiles, p = 0.015). Anti-mhsp65 titres were not predictive.
Conclusions: Patients admitted with acute cardiac chest pain and increased titres of anti-huhsp60 had an adverse one year prognosis.
- BSA, bovine serum albumin
- CABG, coronary artery bypass grafting
- CHD, coronary heart disease
- CI, confidence interval
- CRP, C reactive protein
- ELISA, enzyme linked immunosorbent assay
- hsp, heat shock protein
- huhsp, human heat shock protein
- mhsp, mycobacterial heat shock protein
- MI, myocardial infarction
- PBS, phosphate buffered saline
- PTCA, percutaneous transluminal coronary angioplasty
- atherosclerosis
- inflammation
- prognosis
- antibodies
- heat shock protein 60
- coronary heart disease
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- BSA, bovine serum albumin
- CABG, coronary artery bypass grafting
- CHD, coronary heart disease
- CI, confidence interval
- CRP, C reactive protein
- ELISA, enzyme linked immunosorbent assay
- hsp, heat shock protein
- huhsp, human heat shock protein
- mhsp, mycobacterial heat shock protein
- MI, myocardial infarction
- PBS, phosphate buffered saline
- PTCA, percutaneous transluminal coronary angioplasty
Footnotes
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This research study was funded by a British Heart Foundation Junior Research Fellowship (LEV) and project grant. There are no conflicts of interest to declare.
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The work was performed in the Department of Medical Cardiology, Royal Infirmary, Glasgow, Scotland and the Department of Medicine and Therapeutics, University of Glasgow, Scotland.