Original Research ARTICLE
BETA-1-ADRENERGIC RECEPTOR ANTIBODIES IN ACUTE CORONARY SYNDROME: IS LESS SOMETIMES MORE?
- 1Department of Rheumatology and Immunology, Hannover Medical School, Germany
- 2Department of Cardiology, University of Oldenburg, Germany
- 3CellTrend GmbH, Germany
- 4Universitätsklinikum Schleswig-Holstein, Germany
Background: Anti-beta-1-adrenergic receptor antibodies (anti-β1AR Ab) are associated with ischemic cardiomyopathies (ICM). Evidence continues to emerge supporting an autoimmune component to various cardiac diseases. This study compares anti-β1AR Ab concentrations in patients with different entities of acute coronary syndromes (ACS) to asymptomatic non-ACS patients with positron-emission computed tomography (PET/CT)-proven atherosclerosis, and healthy controls.
Methods: Serum anti-β1AR Ab IgG concentrations were measured in 212 ACS patients, 100 atherosclerosis patients, and 62 controls using ELISA. All ACS patients underwent coronary angiography. All 374 patients participating completed a structured questionnaire regarding traditional cardiovascular risk factors. ACS patients were followed up for 6 months.
Results: Patients with ACS exhibited lower anti-β1AR Ab levels compared to patients with atherosclerosis or healthy controls (both p<0.001). No differences in the ab levels were evident between healthy controls and patients with atherosclerosis. In the ACS groups, lower concentrations were found in patients with ST-elevation myocardial infarction (STEMI) (0.67 µg/ml) compared to patients with angina pectoris (AP) and non-ST elevation myocardial infarction (NSTEMI) (both 0.76 µg/ml, p=0.008). Anti-β1AR Ab levels ≤ 0.772 µg/ml were predictive for death and reinfarction (AUC 0.77, p = 0.006). No significant correlations between anti-β1AR Ab levels and atherosclerotic burden or traditional cardiovascular risk factors were identified.
Conclusions: Lower anti-β1AR Ab concentrations appear to characterize ACS phenotypes and could serve as diagnostic and prognostic markers independent from traditional risk factors for atherosclerosis. The prognostic predictive value of anti-β1AR Ab in ACS remains to be confirmed in larger studies.
Keywords: Anti-beta-1-adrenergic receptor antibodies, biomarker, antibody, Atherosclerosis, Acute Coronary Syndrome, Cardiac risk factor
Received: 31 Aug 2018;
Accepted: 05 Nov 2018.
Edited by:Junjie Xiao, Shanghai University, China
Reviewed by:Tao L. Chan, Nanjing Medical University, China
Guoping Li, Massachusetts General Hospital, Harvard Medical School, United States
Copyright: © 2018 Ernst, Widera, Weiberg, Derlin, Ahrenstorf, Sogkas, Jablonka, Schmidt, Witte, Heidecke and Riemekasten. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Diana Ernst, Hannover Medical School, Department of Rheumatology and Immunology, Hanover, Germany, email@example.com