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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...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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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. |
format | Online Article Text |
id | pubmed-6679072 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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