ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. General Cardiovascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1515693
This article is part of the Research TopicAutoimmune Diseases and Cardiovascular HealthView all 4 articles
Prognostic Role of Angiotensin-II Receptor Type 1 and Endothelin-1 Receptor Type A Agonistic Autoantibodies in Patients With Acute Myocardial Infarction
Provisionally accepted
Francesco Tona*
Giovanni Civieri
Marta Vadori
Giulia Masiero
Laura Iop
Martina Perazzolo Marra
Annagrazia CecereMarika MartiniDonatella Tansella
Giacomo BernavaBenedetta SchiavonLoira Leoni
Emanuele CozziSabino Iliceto- University of Padua, Padua, Italy
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Background: Functional autoantibodies against angiotensin II type 1 (AT1R-AAs) and endothelin-1 type A (ETAR-AAs) receptors are associated with microvascular obstruction and myocardial remodeling after ST-elevation myocardial infarction (STEMI). However, their role in the long-term prognosis after STEMI has not been investigated. Methods: This is a prospective observational study enrolling STEMI patients undergoing early primary PCI. The incidence of major adverse cardiovascular events (MACE) was investigated during the follow-up. Autoantibody seropositivity was defined as a level > 10 U/mL. Results: 200 STEMI patients (89% male, median age 61 years) were enrolled. 110 (55%) were seronegative for both autoantibodies, 44 (22%) were seropositive for one autoantibody, and 46 (23%) were seropositive for both autoantibodies. Over a median follow-up of 1.2 years, the incidence of MACE was higher in patients with double (31%) and single (25%) seropositivity than in seronegative patients (13%, p=0.02 among groups). Double seropositivity was independently associated with higher risk of MACE (HR 2.386, 95 % CI 1.471-3.864, p<0.001). Conclusion: AT1R-AAs and ETAR-AAs are associated with an increased risk of MACE after STEMI. Assessment of autoantibody levels paves the way for future therapies targeting specific molecular pathways associated with poor prognosis after an acute coronary event.
Keywords: Autoimmunity, No Reflow, coronary microcirculation, G protein coupled receptors, Acute Coronary Syndrome, Adverse prognosis, Autoantibodies
Received: 23 Oct 2024; Accepted: 16 Jul 2025.
Copyright: © 2025 Tona, Civieri, Vadori, Masiero, Iop, Marra, Cecere, Martini, Tansella, Bernava, Schiavon, Leoni, Cozzi and Iliceto. 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) or licensor 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: Francesco Tona, University of Padua, Padua, Italy
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