Newer Antiphospholipid Antibodies Predict Adverse Outcomes in Patients With Acute Coronary Syndrome
Newer Antiphospholipid Antibodies Predict Adverse Outcomes in Patients With Acute Coronary Syndrome
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DOI：
10.1309/ajcp2fjut2yzgitk
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发表时间：
2009-10-01
影响因子：
3.5
通讯作者：
Lopez, Luis R.
中科院分区：
文献类型：
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作者：
Greco, Thomas P.;Conti-Kelly, Ann Marie;Lopez, Luis R.
抗磷脂抗体（aPLs）与动脉粥样硬化形成有关。我们研究了344例急性冠状动脉综合征患者;约40%的患者在I或以上试验中为aPL+，60%为aPL-。在215例患者中，冠状动脉疾病（CAD）进行了血管造影记录，43.7%的aft阳性患者与34.9%的无CAD患者aPL阳性。抗β 2-糖蛋白I（B2 GPI; 54%）和抗氧化低密度脂蛋白（oxLDL）/β 2GPI（48%）最常见，占所有aPL+ CAD病例的87%。aPL与CAD严重程度相关（P= 0.012）。16.7%的CAD患者发生不良事件，aPL+患者更常见（P= 0.0006;相对风险为2.9; 95%置信区间为1.5-5.6）。aPL +重度CAD患者的不良事件多于aPL-重度CAD患者（P= 0.005）和接受血运重建术的aPL+患者（P= 0.001）。21.7%的aPL +患者发生血管事件，而aPL-患者为7.1%（P= 0.005）。抗β 2GPI和抗oxLDL/β 2GPI与CAD严重程度和不良结局相关。
Antiphospholipid antibodies (aPLs) have been implicated in atherogenesis. We studied 344 patients with acute coronary syndromes; approximately 40% were aPL+ in I or more tests and 60% aPL-. In 215 patients, coronary artery disease (CAD) was angiographically documented, with 43.7% positive for aft vs 34.9% of patients without CAD positive for aPLs. Anti-beta(2)-glycoprotein I (B2GPI; 54%) and anti-oxidized low-density; lipoprotein (oxLDL)/beta 2GPI (48%) were most frequent, accounting for 87% of all aPL+ CAD cases. aPLs correlated with severity of CAD (P=.012). Adverse events occurred in 16 7% of patients with CAD, more frequently in patients who were aPL+ (P=.0006; relative risk, 2.9; 95% confidence interval, 1.5-5.6). Patients who were aPL + with severe CAD had more adverse events than patients who were aPL- with severe CAD (P=.005) and aPL+patients undergoing revascularization procedures (P=.001). Vascular events occurred in 21.7% of aPL + patients compared with 7.1% of aPL-patients (P=.005). Anti-beta 2GPI and anti-oxLDL/beta 2GPI were associated with CAD severity and adverse outcomes.