Diagnostic and prognostic value of autoantibodies anti-apolipoprotein A-1 and anti-phosphorylcholine in acute non-ST elevation myocardial infarction
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Diagnostic and prognostic value of autoantibodies anti-apolipoprotein A-1 and anti-phosphorylcholine in acute non-ST elevation myocardial infarction. / Rubini Gimenez, Maria; Pagano, Sabrina; Virzi, Julien; Montecucco, Fabrizio; Twerenbold, Raphael; Reichlin, Tobias; Wildi, Karin; Grueter, Daniel; Jaeger, Cedric; Haaf, Philip; Vuilleumier, Nicolas; Mueller, Christian.
in: EUR J CLIN INVEST, Jahrgang 45, Nr. 4, 01.04.2015, S. 369-379.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Diagnostic and prognostic value of autoantibodies anti-apolipoprotein A-1 and anti-phosphorylcholine in acute non-ST elevation myocardial infarction
AU - Rubini Gimenez, Maria
AU - Pagano, Sabrina
AU - Virzi, Julien
AU - Montecucco, Fabrizio
AU - Twerenbold, Raphael
AU - Reichlin, Tobias
AU - Wildi, Karin
AU - Grueter, Daniel
AU - Jaeger, Cedric
AU - Haaf, Philip
AU - Vuilleumier, Nicolas
AU - Mueller, Christian
N1 - Publisher Copyright: © 2015 Stichting European Society for Clinical Investigation Journal Foundation.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Background: Autoantibodies have been shown to play a critical role in predicting major adverse cardiovascular events in atherosclerotic patients. We aimed to assess the diagnostic accuracy of autoantibodies to apolipoprotein A-1 (anti-apoA-1 IgG) and to phosphorylcholine (anti-PC IgM) for non-ST segment elevation acute myocardial infarction (NSTEMI) and to explore their potential prognostic value. Methods: This prospective multicentre study included 1072 patients presenting to the emergency department for suspected NSTEMI. The final diagnosis was adjudicated by two independent cardiologists. For both antibodies alone or expressed as a ratio (anti-apoA-1 IgG/anti-PC IgM), we determined their (i) diagnostic accuracy for NSTEMI and (ii) prognostic accuracy for major adverse cardiovascular events (MACE) during 1-year follow-up. Results: A total of 154 patients (14%) had a final diagnosis of NSTEMI. Diagnostic accuracy for the diagnosis of NSTEMI as quantified by the area under the receiver operating characteristics curve (AUC) was very low for both autoantibodies separately as well as combined as a ratio: AUC anti-apoA-1 IgG 0·50 (95%CI, 0·47-0·53, P = 0·99), AUC anti-PC IgM 0·53 (95%CI, 0·50-0·56, P = 0·30) and AUC of the ratio 0·52 (95%CI, 0·49-0·55, P = 0·47). Adding the anti-apoA-1 IgG/Anti-PC IgM ratio to hs-cTnT did not provide incremental diagnostic value over hs-cTnT alone. MACE occurred in 221 patients (21%) during follow-up. The autoantibodies, separately or expressed as ratio, also had very low accuracy to predict MACE (p=ns). Conclusions: Anti-apoA-1 IgG and anti-PC IgM autoantibodies did not have diagnostic or prognostic value in patients with NSTEMI.
AB - Background: Autoantibodies have been shown to play a critical role in predicting major adverse cardiovascular events in atherosclerotic patients. We aimed to assess the diagnostic accuracy of autoantibodies to apolipoprotein A-1 (anti-apoA-1 IgG) and to phosphorylcholine (anti-PC IgM) for non-ST segment elevation acute myocardial infarction (NSTEMI) and to explore their potential prognostic value. Methods: This prospective multicentre study included 1072 patients presenting to the emergency department for suspected NSTEMI. The final diagnosis was adjudicated by two independent cardiologists. For both antibodies alone or expressed as a ratio (anti-apoA-1 IgG/anti-PC IgM), we determined their (i) diagnostic accuracy for NSTEMI and (ii) prognostic accuracy for major adverse cardiovascular events (MACE) during 1-year follow-up. Results: A total of 154 patients (14%) had a final diagnosis of NSTEMI. Diagnostic accuracy for the diagnosis of NSTEMI as quantified by the area under the receiver operating characteristics curve (AUC) was very low for both autoantibodies separately as well as combined as a ratio: AUC anti-apoA-1 IgG 0·50 (95%CI, 0·47-0·53, P = 0·99), AUC anti-PC IgM 0·53 (95%CI, 0·50-0·56, P = 0·30) and AUC of the ratio 0·52 (95%CI, 0·49-0·55, P = 0·47). Adding the anti-apoA-1 IgG/Anti-PC IgM ratio to hs-cTnT did not provide incremental diagnostic value over hs-cTnT alone. MACE occurred in 221 patients (21%) during follow-up. The autoantibodies, separately or expressed as ratio, also had very low accuracy to predict MACE (p=ns). Conclusions: Anti-apoA-1 IgG and anti-PC IgM autoantibodies did not have diagnostic or prognostic value in patients with NSTEMI.
KW - Acute myocardial infarction
KW - Anti-apoA-1 antibodies
KW - Anti-PC antibodies
KW - NSTEMI diagnosis
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=84925945764&partnerID=8YFLogxK
U2 - 10.1111/eci.12411
DO - 10.1111/eci.12411
M3 - SCORING: Journal article
C2 - 25627775
AN - SCOPUS:84925945764
VL - 45
SP - 369
EP - 379
JO - EUR J CLIN INVEST
JF - EUR J CLIN INVEST
SN - 0014-2972
IS - 4
ER -