Diagnostic and prognostic value of autoantibodies anti-apolipoprotein A-1 and anti-phosphorylcholine in acute non-ST elevation myocardial infarction

TY - JOUR

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 -