Anti-beta 2 glycoprotein I antibodies and the risk of myocardial infarction in young premenopausal women

Pier Luigi Meroni, F. Peyvandi, L. Foco, L. Bernardinelli, R. Fetiveau, P. M. Mannucci, A. Tincani

Research output: Contribution to journalArticle

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Abstract

Background: Contrasting data have been reported on the association between the presence of anti-phospholipid antibodies (aPL) and arterial thrombotic events, particularly those in coronary arteries. This discrepancy is perhaps related to the confounding effect of traditional risk factors. Among them, coronary atherosclerosis appears to be the most important in studies conducted in middle-aged and elderly patients. Objective: To minimize such confounding effects, a multicenter case-control study on the association between aPL and myocardial infarction (MI) was carried out in a rare cohort of young premenopausal women. Methods: We evaluated 172 cases hospitalized for a first MI before the age of 45years and 172 controls individually matched with cases for age, sex and geographical origin. Clinical and laboratory data were collected and levels of anti-cardiolipin (aCL), anti-beta2 glycoprotein I (anti-β2GPI) and anti-nuclear antibodies (ANA) were measured. Results: A significant association between MI and IgG/IgM anti-β2GPI antibodies was observed; the results were confirmed after adjusting for smoking and hypertension (anti-β2GPI IgG OR=2.47, 95% CI 1.81-3.38; anti-β2GPI IgM 4th quartile OR 3.68, 95% CI 1.69-8.02). The association between anti-β2GPI antibodies and MI was detected in both subgroups with and without coronary artery stenosis. Whereas the association of aCL IgG with MI was modest, ANA showed no significant association with MI. No aPL were found in unselected patients (mainly males) who recently developed acute MI. Conclusions: Anti-β2GPI antibodies are a significant risk factor for MI in young premenopausal women independently of other risk factors, including the degree of coronary artery stenosis.

Original languageEnglish
Pages (from-to)2421-2428
Number of pages8
JournalJournal of Thrombosis and Haemostasis
Volume5
Issue number12
DOIs
Publication statusPublished - Dec 2007

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beta 2-Glycoprotein I
Myocardial Infarction
Anti-Idiotypic Antibodies
Antibodies
Phospholipids
Cardiolipins
Coronary Stenosis
Immunoglobulin M
Case-Control Studies
Coronary Artery Disease
Coronary Vessels
Immunoglobulin G
Smoking
Hypertension

Keywords

  • Anti-beta2 glycoprotein I antibodies
  • Anti-phospholipid antibodies
  • Myocardial infarction
  • Premenopausal women

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Anti-beta 2 glycoprotein I antibodies and the risk of myocardial infarction in young premenopausal women. / Meroni, Pier Luigi; Peyvandi, F.; Foco, L.; Bernardinelli, L.; Fetiveau, R.; Mannucci, P. M.; Tincani, A.

In: Journal of Thrombosis and Haemostasis, Vol. 5, No. 12, 12.2007, p. 2421-2428.

Research output: Contribution to journalArticle

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abstract = "Background: Contrasting data have been reported on the association between the presence of anti-phospholipid antibodies (aPL) and arterial thrombotic events, particularly those in coronary arteries. This discrepancy is perhaps related to the confounding effect of traditional risk factors. Among them, coronary atherosclerosis appears to be the most important in studies conducted in middle-aged and elderly patients. Objective: To minimize such confounding effects, a multicenter case-control study on the association between aPL and myocardial infarction (MI) was carried out in a rare cohort of young premenopausal women. Methods: We evaluated 172 cases hospitalized for a first MI before the age of 45years and 172 controls individually matched with cases for age, sex and geographical origin. Clinical and laboratory data were collected and levels of anti-cardiolipin (aCL), anti-beta2 glycoprotein I (anti-β2GPI) and anti-nuclear antibodies (ANA) were measured. Results: A significant association between MI and IgG/IgM anti-β2GPI antibodies was observed; the results were confirmed after adjusting for smoking and hypertension (anti-β2GPI IgG OR=2.47, 95{\%} CI 1.81-3.38; anti-β2GPI IgM 4th quartile OR 3.68, 95{\%} CI 1.69-8.02). The association between anti-β2GPI antibodies and MI was detected in both subgroups with and without coronary artery stenosis. Whereas the association of aCL IgG with MI was modest, ANA showed no significant association with MI. No aPL were found in unselected patients (mainly males) who recently developed acute MI. Conclusions: Anti-β2GPI antibodies are a significant risk factor for MI in young premenopausal women independently of other risk factors, including the degree of coronary artery stenosis.",
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AU - Meroni, Pier Luigi

AU - Peyvandi, F.

AU - Foco, L.

AU - Bernardinelli, L.

AU - Fetiveau, R.

AU - Mannucci, P. M.

AU - Tincani, A.

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N2 - Background: Contrasting data have been reported on the association between the presence of anti-phospholipid antibodies (aPL) and arterial thrombotic events, particularly those in coronary arteries. This discrepancy is perhaps related to the confounding effect of traditional risk factors. Among them, coronary atherosclerosis appears to be the most important in studies conducted in middle-aged and elderly patients. Objective: To minimize such confounding effects, a multicenter case-control study on the association between aPL and myocardial infarction (MI) was carried out in a rare cohort of young premenopausal women. Methods: We evaluated 172 cases hospitalized for a first MI before the age of 45years and 172 controls individually matched with cases for age, sex and geographical origin. Clinical and laboratory data were collected and levels of anti-cardiolipin (aCL), anti-beta2 glycoprotein I (anti-β2GPI) and anti-nuclear antibodies (ANA) were measured. Results: A significant association between MI and IgG/IgM anti-β2GPI antibodies was observed; the results were confirmed after adjusting for smoking and hypertension (anti-β2GPI IgG OR=2.47, 95% CI 1.81-3.38; anti-β2GPI IgM 4th quartile OR 3.68, 95% CI 1.69-8.02). The association between anti-β2GPI antibodies and MI was detected in both subgroups with and without coronary artery stenosis. Whereas the association of aCL IgG with MI was modest, ANA showed no significant association with MI. No aPL were found in unselected patients (mainly males) who recently developed acute MI. Conclusions: Anti-β2GPI antibodies are a significant risk factor for MI in young premenopausal women independently of other risk factors, including the degree of coronary artery stenosis.

AB - Background: Contrasting data have been reported on the association between the presence of anti-phospholipid antibodies (aPL) and arterial thrombotic events, particularly those in coronary arteries. This discrepancy is perhaps related to the confounding effect of traditional risk factors. Among them, coronary atherosclerosis appears to be the most important in studies conducted in middle-aged and elderly patients. Objective: To minimize such confounding effects, a multicenter case-control study on the association between aPL and myocardial infarction (MI) was carried out in a rare cohort of young premenopausal women. Methods: We evaluated 172 cases hospitalized for a first MI before the age of 45years and 172 controls individually matched with cases for age, sex and geographical origin. Clinical and laboratory data were collected and levels of anti-cardiolipin (aCL), anti-beta2 glycoprotein I (anti-β2GPI) and anti-nuclear antibodies (ANA) were measured. Results: A significant association between MI and IgG/IgM anti-β2GPI antibodies was observed; the results were confirmed after adjusting for smoking and hypertension (anti-β2GPI IgG OR=2.47, 95% CI 1.81-3.38; anti-β2GPI IgM 4th quartile OR 3.68, 95% CI 1.69-8.02). The association between anti-β2GPI antibodies and MI was detected in both subgroups with and without coronary artery stenosis. Whereas the association of aCL IgG with MI was modest, ANA showed no significant association with MI. No aPL were found in unselected patients (mainly males) who recently developed acute MI. Conclusions: Anti-β2GPI antibodies are a significant risk factor for MI in young premenopausal women independently of other risk factors, including the degree of coronary artery stenosis.

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