Article Text

PDF
Coronary artery disease
IgA anticardiolipin antibody is associated with the extent of daily-life ischaemia in patients with chronic coronary artery disease
  1. Ignatios Ikonomidis1,
  2. John Lekakis1,
  3. Georgia Vamvakou1,
  4. Sozos Loizou2,
  5. Ioanna Revela1,
  6. Felicita Andreotti2,
  7. Dimitrios T Kremastinos1,
  8. Petros Nihoyannopoulos2
  1. 1
    2nd Cardiology Department, Attikon Hospital, University of Athens, Greece
  2. 2
    Imperial College School of Medicine, National Heart & Lung Institute, Cardiology Department, Hammersmith Hospital, London, UK
  1. Ignatios Ikonomidis, 2nd Cardiology Department, Attikon Hospital, University of Athens, Perikleous 19, N. Chalkidona, Athens, 14343, Greece; ignoik{at}otenet.gr

Abstract

Background: Circulating anticardiolipin antibodies (aCL) may cause endothelial dysfunction. We investigated whether aCL are related to platelet activation, thrombin generation and daily-life ischaemia in patients with chronic coronary artery disease (CAD).

Methods: We measured (medians 25th–75th percentile) IgG, IgM, IgA aCL serum levels (Arbitrary Elisa Units, AEU), prothrombin fragments (F1+2, nmol/l), 24 h urine excretion of 11-dehydrothromboxane B2 (11-DHTXB2, ng/mg creatinine) creatine kinase (CK) and its cardiac isoenzyme CK-MB (IU/l) in 60 patients with angiographically documented CAD and in 40 age and sex matched controls. Patients underwent a 48 h Holter monitoring for assessment of the number and duration of ischaemic episodes.

Results: Patients had higher IgA-aCL levels than controls (3.2 vs 2.4 AEU, p = 0.002). Increased IgA-ACA levels were related to increased number and duration of ischaemic episodes (p<0.01). By ANOVA, patients with ⩾10 ischaemic episodes (3rd tertile) or duration of ischaemia ⩾32min (3rd tertile) had higher IgA-aCL than those with lower ischaemic burden (4.95 vs 3 vs 2.5 AEU, p = 0.002 and 4.9 vs 3 vs 2.5 AEU, p = 0.001 respectively). Patients with ⩾2 ischaemic episodes (2nd and 3rd tertile) had higher 11-DHTXB2, than those with minimal ischaemia (2< episodes, 1st tertile) (p = 0.001). CK and CK-MB were within normal range after Holter monitoring. Receiver operating curve analysis showed a greater area under the curve for IgA-aCL than for 11-DHTXB2 in predicting severe ischaemia (⩾10 ischemic episodes or ⩾32 min duration of ischaemia).

Conclusion: Increasing IgA-aCL levels are associated with increasing ischemic burden in patients with CAD.

Statistics from Altmetric.com

Footnotes

  • Competing interests: None declared.

  • Abbreviations:
    aCL
    anticardiolipin antibodies
    AUC
    areas under the curves
    CK
    creatine kinase
    HM
    Holter monitoring
    ROC
    receiver operating characteristic curve

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.