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13-02-2012 | Cardiometabolic | Article

Low levels of lipid antibodies associated with MACE risk in ACS

Abstract

Free abstract

MedWire News: Measuring levels of an immune system antibody could improve risk prediction in patients with acute coronary syndromes (ACS), suggest study findings.

Kenneth Caidahl (Karolinska Institute, Stockholm, Sweden) and colleagues found that low levels of immunoglobulin-M (IgM) autoantibodies against proinflammatory phosphorylcholine (anti-PC) significantly and independently predict major acute cardiovascular events (MACE) and all-cause mortality in ACS patients.

"Low anti-PC titers are a novel risk marker after ACS," they write, adding that serum IgM anti-PC titers could therefore be used to identify risk groups in need of intensified secondary prevention.

Previous studies have shown that atherosclerosis development and cardiovascular disease risk are inversely correlated with serum anti-PC titers. Caidahl et al therefore sought to determine whether low levels of IgM anti-PC titers add prognostic information in ACS.

A total of 1185 ACS patients (median age 66 years, 30% women) whose serum IgM anti-PC titers were measured within 24 hours of admission were included in the study.

MACE and all-cause mortality were evaluated at 6 (short-term follow-up), 18 (intermediate-term), and 72 (long-term) months.

Low levels of anti-PC titers (≥26.4 IU) were significantly associated with MACE and all-cause mortality at all follow-up times, reports the team. After adjusting for clinical variables, plasma troponin-1, B-type natriuretic peptide, and C-reactive protein levels, significant associations remained at all follow-up times with MACE, and short and intermediate terms for all-cause mortality.

Indeed, at 18 months, individuals with low levels of anti-PC titers had a 1.53-fold increased risk for MACE and a 1.71-fold increased risk for all-cause mortality compared with those with anti-PC titers above 26.4 IU.

Writing in the International Journal of Cardiology, the researchers propose that anti-PC supplementation, or stimulation to increase anti-PC production, could have beneficial effects in ACS patients.

They suggest that future studies should investigate the potential of anti-PC as a possible immunotherapy in ACS.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Nikki Withers