High Prevalence of Anti-β2 Glycoprotein I Antibodies in Patients with Ischemic Heart Disease

Abstract

Ischemic cardiac manifestations have been reported in a various percentage of patients with anti-phospholipid antibodies. As concerns the relationship between anti-beta2 glycoprotein I antibodies (anti-beta2-GPI) and ischemic heart disease (IHD), it was investigated in only one coronary primary prevention study. We investigated the prevalence of anti-beta2-GPI in a well characterized group of patients with different clinical manifestation of IHD. Sera from 37 patients (mean age 62.7 +/- 9.9) with IHD (20 with unstable angina-UA and 17 with effort angina-EA) and from 40 healthy subjects, matched for age and sex, were tested for the presence of IgG and IgM anti-beta2-GPI using an ELISA technique. Eleven/37 patients (29.7%) resulted positive for anti-beta2-GPI. A positivity for IgG anti-beta2-GPI was found in 10 patients, 1 patient was positive for IgM and 1 for both isotypes. The prevalence of anti-beta2-GPI in the control group resulted significantly lower (2.5%; p < 0.005) than in patients with IHD. Positivity for anti-beta2-GPI was found in 9/20 (45%) patients with UA and only in 2/17 patients (11.8%) with EA (p = 0.0365). IgG anti-beta2-GPI levels (median 7.7U/ml, range 2.6-24.1) were significantly higher in patients with UA compared to patients with EA (median 4.6 U/ml, range 2.3-11.5; p = 0.02) and controls (median 3.15 U/ml, range 2.3-9.0; p < 0.0001); also IgM levels resulted higher in patients with unstable angina. A positivity for anti-beta2-GPI was observed in 4/13 patients (30.8%) with a previous myocardial infarction (MI) and in 7/24 (29.2%) patients without a previous MI. Our findings suggest that anti-beta2-GPI could represent an expression of the T-cell activation detectable in patients with unstable angina. The lack of a significant difference in the prevalence of these antibodies in patients with or without a previous MI suggests that anti-beta2-GPI are not induced by tissue necrosis.

Antiphospholipid antibodies as a possible risk factor for atherosclerosis in patients with rheumatoid arthritis

“…We reported a slightly different study where positive antib2GPI of any Ig class were detected in 11% of nonselected RA patients (Ambrozˇicˇet al, 2002a). Farsi et al (1999) related IgG anti-b2GPI with coronary atherosclerosis. However, data from the Honolulu heart program (Brey et al, 2001) showed insignificant frequency of IgG anti-b2GPI in patients with atherosclerosis compared to controls.…”

Assessment of Hemostatic Risk Factors in Predicting Arterial Thrombotic Events

“…In a recent study by Veres et al, 42 the authors report that the frequency and titers of anti-␤ 2 -GPI antibodies were significantly higher in patients with acute coronary syndromes than in controls, data that are consistent with previous studies on patients with stable and unstable angina. 43 Building on these observations, de Laat et al 44 developed an assay to discriminate between ␤ 2 -GPI antibody-dependent LA and ␤ 2 -GPI-independent LA activity. They subsequently applied this assay to a retrospective cohort of 198 patients with either systemic lupus erythematosus (SLE; nϭ176), lupus-like disease (nϭ16), or primary antiphospholipid syndrome (nϭ6) and found that among the 58 patients with LA, 25 had ␤ 2 -GPI antibody-dependent LA activity.…”

Anti-β2-glycoprotein I antibodies of IgM class are linked to thrombotic disorders in young women without autoimmune disease

“…Evidence suggesting a relationship between anti-b2GPI and the risk of arterial and venous thrombosis in these patients is not so abundant and uniform results have not been found. The predominance of isotype IgG, or IgM, or both, or none has been reported in different groups of patients with different localization of the thrombosis (Forastiero et al, 1999;Zanon et al, 1999;Farsi et al, 1999;Galli et al, 2000;Brey et al, 2001;Previtali et al, 2002). Evidently, additional data focused on strictly defined subgroups of patients are needed.…”