Document Detail


Anti-apolipoprotein A-1 IgG as an independent cardiovascular prognostic marker affecting basal heart rate in myocardial infarction.
MedLine Citation:
PMID:  20176799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To assess the prognostic value of anti-apolipoprotein A-1 (anti-apoA-1) IgG after myocardial infarction (MI) and its association with major cardiovascular events (MACEs) at 12 months and to determine their association with resting heart rate (RHR), a well-established prognostic feature after MI. Anti-apoA-1 IgG have been reported in MI without autoimmune disease, but their clinical significance remains undetermined. METHODS AND RESULTS: A total of 221 consecutive patients with MI were prospectively included, and all completed a 12-month follow-up. Major cardiovascular events consisted in death, MI, stroke, or hospitalization either for an acute coronary syndrome or heart failure. Resting heart rate was obtained on Holter the day before discharge under the same medical treatment. Neonate rat ventricular cardiomyocytes (NRVC) were used in vitro to assess the direct anti-apoA-1 IgG effect on RHR. During follow-up, 13% of patients presented a MACE. Anti-apoA-1 IgG positivity was 9% and was associated with a higher RHR (P = 0.0005) and higher MACE rate (adjusted OR, 4.3; 95% CI, 1.46-12.6; P = 0.007). Survival models confirmed the significant nature of this association. Patients with MACE had higher median anti-apoA-1 IgG values at admission than patients without (P = 0.007). On NRVC, plasma from MI patients and monoclonal anti-apoA-1 IgG induced an aldosterone and dose-dependent positive chronotropic effect, abrogated by apoA-1 and therapeutic immunoglobulin (IVIG) pre-incubation. CONCLUSIONS: In MI patients, anti-apoA-1 IgG is independently associated with MACE at 1-year, interfering with a currently unknown aldosterone-dependent RHR determinant. Knowing whether anti-apoA-1 IgG assessment could be of interest to identify an MI patient subset susceptible to benefit from apoA-1/IVIG therapy remains to be demonstrated.
Authors:
Nicolas Vuilleumier; Michel F Rossier; Sabrina Pagano; Magaly Python; Emmanuel Charbonney; René Nkoulou; Richard James; Guido Reber; François Mach; Pascale Roux-Lombard
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-22
Journal Detail:
Title:  European heart journal     Volume:  31     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-02     Completed Date:  2010-09-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  815-23     Citation Subset:  IM    
Affiliation:
Service of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals, Geneva 14, Switzerland. nicolas.vuilleumier@hcuge.ch
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / mortality
Adult
Aged
Aged, 80 and over
Animals
Apolipoprotein A-I / immunology*
Arrhythmias, Cardiac / diagnosis*,  physiopathology
Biological Markers / metabolism
Dose-Response Relationship, Immunologic
Enzyme-Linked Immunosorbent Assay
Female
Heart Failure / mortality
Heart Rate / immunology
Humans
Immunoglobulin G / metabolism*
Male
Middle Aged
Myocardial Infarction / diagnosis*,  mortality,  physiopathology
Myocytes, Cardiac / immunology
Prognosis
Prospective Studies
Rats
Rats, Wistar
Reference Values
Reproducibility of Results
Stroke / mortality
Treatment Outcome
Chemical
Reg. No./Substance:
0/Apolipoprotein A-I; 0/Biological Markers; 0/Immunoglobulin G

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