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Non-Linear Relationship between Anti-Apolipoprotein A-1 IgGs and Cardiovascular Outcomes in Patients with Acute Coronary Syndromes

Autoantibodies against apolipoprotein A-I (anti-apoA-I IgGs) are prevalent in atherosclerosis-related conditions. It remains elusive whether they improve the prognostic accuracy of the Global Registry of Acute Coronary Events (GRACE) score 2.0 (GS) in acute coronary syndromes (ACS). In this prospect...

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Autores principales: Vuilleumier, Nicolas, Pagano, Sabrina, Combescure, Christophe, Gencer, Baris, Virzi, Julien, Räber, Lorenz, Carballo, David, Carballo, Sebastian, Nanchen, David, Rodondi, Nicolas, Windecker, Stephan, Hazen, Stanley L., Wang, Zeneng, Li, Xinmin S., von Eckardstein, Arnold, Matter, Christian M., Lüscher, Thomas F., Klingenberg, Roland, Mach, Francois
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679072/
https://www.ncbi.nlm.nih.gov/pubmed/31324073
http://dx.doi.org/10.3390/jcm8071002
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author Vuilleumier, Nicolas
Pagano, Sabrina
Combescure, Christophe
Gencer, Baris
Virzi, Julien
Räber, Lorenz
Carballo, David
Carballo, Sebastian
Nanchen, David
Rodondi, Nicolas
Windecker, Stephan
Hazen, Stanley L.
Wang, Zeneng
Li, Xinmin S.
von Eckardstein, Arnold
Matter, Christian M.
Lüscher, Thomas F.
Klingenberg, Roland
Mach, Francois
author_facet Vuilleumier, Nicolas
Pagano, Sabrina
Combescure, Christophe
Gencer, Baris
Virzi, Julien
Räber, Lorenz
Carballo, David
Carballo, Sebastian
Nanchen, David
Rodondi, Nicolas
Windecker, Stephan
Hazen, Stanley L.
Wang, Zeneng
Li, Xinmin S.
von Eckardstein, Arnold
Matter, Christian M.
Lüscher, Thomas F.
Klingenberg, Roland
Mach, Francois
author_sort Vuilleumier, Nicolas
collection PubMed
description Autoantibodies against apolipoprotein A-I (anti-apoA-I IgGs) are prevalent in atherosclerosis-related conditions. It remains elusive whether they improve the prognostic accuracy of the Global Registry of Acute Coronary Events (GRACE) score 2.0 (GS) in acute coronary syndromes (ACS). In this prospective multicenter registry, 1713 ACS patients were included and followed for 1 year. The primary endpoint (major adverse cardiovascular events (MACE)) was defined as the composite of myocardial infarction, stroke (including transient ischemic attack), or cardiovascular (CV) death with individual events independently adjudicated. Plasma levels of anti-apoA-I IgGs upon study inclusion were assessed using ELISA. The association between anti-apoA-I IgGs and incident MACE was assessed using Cox models with splines and C-statistics. One-year MACE incidence was 8.4% (144/1713). Anti-apoA-I IgG levels were associated with MACE with a non-linear relationship (p = 0.01), which remained unchanged after adjusting for the GS (p = 0.04). The hazard increased progressively across the two first anti-apoA-I IgG quartiles before decreasing thereafter. Anti-apoA-I IgGs marginally improved the prognostic accuracy of the GS (c-statistics increased from 0.68 to 0.70). In this multicenter study, anti-apoA-I IgGs were predictive of incident MACE in ACS independently of the GS but in a nonlinear manner. The practical implications of these findings remain to be defined.
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spelling pubmed-66790722019-08-19 Non-Linear Relationship between Anti-Apolipoprotein A-1 IgGs and Cardiovascular Outcomes in Patients with Acute Coronary Syndromes Vuilleumier, Nicolas Pagano, Sabrina Combescure, Christophe Gencer, Baris Virzi, Julien Räber, Lorenz Carballo, David Carballo, Sebastian Nanchen, David Rodondi, Nicolas Windecker, Stephan Hazen, Stanley L. Wang, Zeneng Li, Xinmin S. von Eckardstein, Arnold Matter, Christian M. Lüscher, Thomas F. Klingenberg, Roland Mach, Francois J Clin Med Article Autoantibodies against apolipoprotein A-I (anti-apoA-I IgGs) are prevalent in atherosclerosis-related conditions. It remains elusive whether they improve the prognostic accuracy of the Global Registry of Acute Coronary Events (GRACE) score 2.0 (GS) in acute coronary syndromes (ACS). In this prospective multicenter registry, 1713 ACS patients were included and followed for 1 year. The primary endpoint (major adverse cardiovascular events (MACE)) was defined as the composite of myocardial infarction, stroke (including transient ischemic attack), or cardiovascular (CV) death with individual events independently adjudicated. Plasma levels of anti-apoA-I IgGs upon study inclusion were assessed using ELISA. The association between anti-apoA-I IgGs and incident MACE was assessed using Cox models with splines and C-statistics. One-year MACE incidence was 8.4% (144/1713). Anti-apoA-I IgG levels were associated with MACE with a non-linear relationship (p = 0.01), which remained unchanged after adjusting for the GS (p = 0.04). The hazard increased progressively across the two first anti-apoA-I IgG quartiles before decreasing thereafter. Anti-apoA-I IgGs marginally improved the prognostic accuracy of the GS (c-statistics increased from 0.68 to 0.70). In this multicenter study, anti-apoA-I IgGs were predictive of incident MACE in ACS independently of the GS but in a nonlinear manner. The practical implications of these findings remain to be defined. MDPI 2019-07-09 /pmc/articles/PMC6679072/ /pubmed/31324073 http://dx.doi.org/10.3390/jcm8071002 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Vuilleumier, Nicolas
Pagano, Sabrina
Combescure, Christophe
Gencer, Baris
Virzi, Julien
Räber, Lorenz
Carballo, David
Carballo, Sebastian
Nanchen, David
Rodondi, Nicolas
Windecker, Stephan
Hazen, Stanley L.
Wang, Zeneng
Li, Xinmin S.
von Eckardstein, Arnold
Matter, Christian M.
Lüscher, Thomas F.
Klingenberg, Roland
Mach, Francois
Non-Linear Relationship between Anti-Apolipoprotein A-1 IgGs and Cardiovascular Outcomes in Patients with Acute Coronary Syndromes
title Non-Linear Relationship between Anti-Apolipoprotein A-1 IgGs and Cardiovascular Outcomes in Patients with Acute Coronary Syndromes
title_full Non-Linear Relationship between Anti-Apolipoprotein A-1 IgGs and Cardiovascular Outcomes in Patients with Acute Coronary Syndromes
title_fullStr Non-Linear Relationship between Anti-Apolipoprotein A-1 IgGs and Cardiovascular Outcomes in Patients with Acute Coronary Syndromes
title_full_unstemmed Non-Linear Relationship between Anti-Apolipoprotein A-1 IgGs and Cardiovascular Outcomes in Patients with Acute Coronary Syndromes
title_short Non-Linear Relationship between Anti-Apolipoprotein A-1 IgGs and Cardiovascular Outcomes in Patients with Acute Coronary Syndromes
title_sort non-linear relationship between anti-apolipoprotein a-1 iggs and cardiovascular outcomes in patients with acute coronary syndromes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679072/
https://www.ncbi.nlm.nih.gov/pubmed/31324073
http://dx.doi.org/10.3390/jcm8071002
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