Armin Imhof1, Wolfgang Koenig2, Andrea Jaensch3, Ute Mons4, Hermann Brenner4, Dietrich Rothenbacher5. 1. Dept. of Internal Medicine II - Cardiology, University of Ulm Medical Centre, Ulm, Germany. 2. Dept. of Internal Medicine II - Cardiology, University of Ulm Medical Centre, Ulm, Germany; Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. Electronic address: koenig@dhm.mhn.de. 3. Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany. 4. Division of Clinical Epidemiology and Aging Research C070, German Cancer Research Center (DKFZ), Heidelberg, Germany. 5. Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Division of Clinical Epidemiology and Aging Research C070, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Abstract
BACKGROUND: Low concentrations of IgM-phosphorylcholine autoantibodies (IgM-anti-PC) have been shown to be associated with increased risk of incident cardiovascular disease (CVD) events and total mortality in patients suffering from an acute coronary syndrome. We assessed whether IgM-anti-PC concentrations add prognostic information for cardiovascular risk in patients with known stable coronary artery disease (CAD). METHODS: IgM-anti-PC concentrations were measured in serum obtained from 1062 patients with clinically manifest stable CAD at baseline. The relation of IgM-anti PC concentrations with CVD events during long-term follow-up was assessed by the Kaplan-Meier and life table method and quantified by means of the log-rank test. Then, Cox proportional hazards regression analysis was performed to assess the independent association of IgM anti-PC concentration with risk of secondary CVD events after adjustment for established and emerging risk factors. RESULTS: In n = 1062 patients with stable CAD only very low IgM anti-PC serum concentrations were associated with increased risk for future fatal and non-fatal coronary events (n = 201 during median of 10 years of follow-up). Among patients with IgM anti-PC concentrations in the lowest decile, the partly adjusted hazard ratio for fatal and non-fatal coronary events was 1.60 (95% confidence interval (CI) 1.01-2.55) compared to the top quartile and 1.94 (95%-CI 1.18-3.18) after adjustment for multiple covariates. CONCLUSION: In patients with stable CAD, very low concentrations of IgM anti-PC are associated with increased risk for fatal and non-fatal future coronary events and thus may add prognostic information to traditional cardiovascular risk factors among these patients.
BACKGROUND: Low concentrations of IgM-phosphorylcholine autoantibodies (IgM-anti-PC) have been shown to be associated with increased risk of incident cardiovascular disease (CVD) events and total mortality in patients suffering from an acute coronary syndrome. We assessed whether IgM-anti-PC concentrations add prognostic information for cardiovascular risk in patients with known stable coronary artery disease (CAD). METHODS: IgM-anti-PC concentrations were measured in serum obtained from 1062 patients with clinically manifest stable CAD at baseline. The relation of IgM-anti PC concentrations with CVD events during long-term follow-up was assessed by the Kaplan-Meier and life table method and quantified by means of the log-rank test. Then, Cox proportional hazards regression analysis was performed to assess the independent association of IgM anti-PC concentration with risk of secondary CVD events after adjustment for established and emerging risk factors. RESULTS: In n = 1062 patients with stable CAD only very low IgM anti-PC serum concentrations were associated with increased risk for future fatal and non-fatal coronary events (n = 201 during median of 10 years of follow-up). Among patients with IgM anti-PC concentrations in the lowest decile, the partly adjusted hazard ratio for fatal and non-fatal coronary events was 1.60 (95% confidence interval (CI) 1.01-2.55) compared to the top quartile and 1.94 (95%-CI 1.18-3.18) after adjustment for multiple covariates. CONCLUSION: In patients with stable CAD, very low concentrations of IgM anti-PC are associated with increased risk for fatal and non-fatal future coronary events and thus may add prognostic information to traditional cardiovascular risk factors among these patients.
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