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Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome
Although several risk factors exist for acute coronary syndrome (ACS) no biomarkers for survival or risk of re-infarction have been validated. Previously, reduced serum concentrations of anti-ß(1)AR Ab have been implicated in poorer ACS outcomes. This study further evaluates the prognostic implicati...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6787077/ https://www.ncbi.nlm.nih.gov/pubmed/31601947 http://dx.doi.org/10.1038/s41598-019-51125-9 |
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author | Ernst, Diana Westerbergh, Johan Sogkas, Georgios Jablonka, Alexandra Ahrenstorf, Gerrit Schmidt, Reinhold Ernst Heidecke, Harald Wallentin, Lars Riemekasten, Gabriela Witte, Torsten |
author_facet | Ernst, Diana Westerbergh, Johan Sogkas, Georgios Jablonka, Alexandra Ahrenstorf, Gerrit Schmidt, Reinhold Ernst Heidecke, Harald Wallentin, Lars Riemekasten, Gabriela Witte, Torsten |
author_sort | Ernst, Diana |
collection | PubMed |
description | Although several risk factors exist for acute coronary syndrome (ACS) no biomarkers for survival or risk of re-infarction have been validated. Previously, reduced serum concentrations of anti-ß(1)AR Ab have been implicated in poorer ACS outcomes. This study further evaluates the prognostic implications of anti-ß(1)AR-Ab levels at the time of ACS onset. Serum anti-ß(1)AR Ab concentrations were measured in randomly selected patients from within the PLATO cohort. Stratification was performed according to ACS event: ST-elevation myocardial infarct (STEMI) vs. non-ST elevation myocardial infarct (NSTEMI). Antibody concentrations at ACS presentation were compared to 12-month all-cause and cardiovascular mortality, as well as 12-month re-infarction. Sub-analysis, stratifying for age and the correlation between antibody concentration and conventional cardiac risk-factors was subsequently performed. Serum anti-ß(1)AR Ab concentrations were measured in 400/799 (50%) STEMI patients and 399 NSTEMI patients. Increasing anti-ß(1)AR Ab concentrations were associated with STEMI (p = 0.001). Across all ACS patients, no associations between anti-ß(1)AR Ab concentration and either all-cause cardiovascular death or myocardial re-infarction (p = 0.14) were evident. However among STEMI patients ≤60 years with anti-ß(1)AR Ab concentration <median higher rates of re-infarction were observed, compared to those with anti-ß(1)AR Ab concentrations > median (14/198 (7.1%) vs. 2/190 (1.1%)); p = 0.01). Similarly, the same sub-group demonstrated greater risk of cardiovascular death in year 1, including re-infarction and stroke (22/198 (11.1%) vs. 10/190 (5.3%); p = 0.017). ACS Patients ≤60 years, exhibiting lower concentrations of ß(1)AR Ab carry a greater risk for early re-infarction and cardiovascular death. Large, prospective studies quantitatively assessing the prognostic relevance of Anti-ß(1)AR Ab levels should be considered. |
format | Online Article Text |
id | pubmed-6787077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-67870772019-10-17 Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome Ernst, Diana Westerbergh, Johan Sogkas, Georgios Jablonka, Alexandra Ahrenstorf, Gerrit Schmidt, Reinhold Ernst Heidecke, Harald Wallentin, Lars Riemekasten, Gabriela Witte, Torsten Sci Rep Article Although several risk factors exist for acute coronary syndrome (ACS) no biomarkers for survival or risk of re-infarction have been validated. Previously, reduced serum concentrations of anti-ß(1)AR Ab have been implicated in poorer ACS outcomes. This study further evaluates the prognostic implications of anti-ß(1)AR-Ab levels at the time of ACS onset. Serum anti-ß(1)AR Ab concentrations were measured in randomly selected patients from within the PLATO cohort. Stratification was performed according to ACS event: ST-elevation myocardial infarct (STEMI) vs. non-ST elevation myocardial infarct (NSTEMI). Antibody concentrations at ACS presentation were compared to 12-month all-cause and cardiovascular mortality, as well as 12-month re-infarction. Sub-analysis, stratifying for age and the correlation between antibody concentration and conventional cardiac risk-factors was subsequently performed. Serum anti-ß(1)AR Ab concentrations were measured in 400/799 (50%) STEMI patients and 399 NSTEMI patients. Increasing anti-ß(1)AR Ab concentrations were associated with STEMI (p = 0.001). Across all ACS patients, no associations between anti-ß(1)AR Ab concentration and either all-cause cardiovascular death or myocardial re-infarction (p = 0.14) were evident. However among STEMI patients ≤60 years with anti-ß(1)AR Ab concentration <median higher rates of re-infarction were observed, compared to those with anti-ß(1)AR Ab concentrations > median (14/198 (7.1%) vs. 2/190 (1.1%)); p = 0.01). Similarly, the same sub-group demonstrated greater risk of cardiovascular death in year 1, including re-infarction and stroke (22/198 (11.1%) vs. 10/190 (5.3%); p = 0.017). ACS Patients ≤60 years, exhibiting lower concentrations of ß(1)AR Ab carry a greater risk for early re-infarction and cardiovascular death. Large, prospective studies quantitatively assessing the prognostic relevance of Anti-ß(1)AR Ab levels should be considered. Nature Publishing Group UK 2019-10-10 /pmc/articles/PMC6787077/ /pubmed/31601947 http://dx.doi.org/10.1038/s41598-019-51125-9 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Ernst, Diana Westerbergh, Johan Sogkas, Georgios Jablonka, Alexandra Ahrenstorf, Gerrit Schmidt, Reinhold Ernst Heidecke, Harald Wallentin, Lars Riemekasten, Gabriela Witte, Torsten Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome |
title | Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome |
title_full | Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome |
title_fullStr | Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome |
title_full_unstemmed | Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome |
title_short | Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome |
title_sort | lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6787077/ https://www.ncbi.nlm.nih.gov/pubmed/31601947 http://dx.doi.org/10.1038/s41598-019-51125-9 |
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