Abstract
The aim of this study was to examine whether detection of coronary calcium and the
autoimmune response associated with atherosclerosis, either solely or in combination,
are different in patients with typical and atypical chest pain. Coronary calcium as
detected by spiral computerized tomography and levels of antibodies against cardiolipin
(CL), oxidized low-density lipoprotein (ox-LDL), and β2-glycoprotein-I (β2-GPI) were
studied in patients with typical chest pain (n = 52), atypical chest pain (n = 19),
or without chest pain (n = 21). Patients with typical chest pain had higher mean levels
of coronary calcium (expressed as natural transformation of total coronary calcium
score) compared with patients with atypical chest pain and controls (5.04 vs 3.21
and 2.75, respectively; p <0.001). The levels of anti-CL were (mean ± SD of optical
density multiplied by 1,000): 262 ± 140, 170 ± 82, and 230 ± 115 for patients with
typical chest pain, atypical chest pain, and controls, respectively (p = 0.016). No
significant difference was found between groups regarding anti-ox-LDL and anti-β2-GPI
autoantibody levels. In the typical chest pain group, there was a higher prevalence
of high total coronary calcium scores (p = 0.03) and high anti-CL levels (p = 0.01)
than in the atypical chest pain group. Eighteen of 52 patients with typical chest
pain (35%) had both high calcium scores and high antibody levels, whereas none of
the 19 patients (0%) who had atypical chest pain had high levels of both (p = 0.003).
A combination of both coronary calcium and anti-CL was associated with higher area
under the receiver operator characteristic curves than for each separately. High coronary
calcium scores or high anti-CL levels are found more often in typical than in atypical
chest pain patients, but a combination of high levels of both can better differentiate
typical from atypical chest pain patients.
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Article Info
Publication History
Accepted:
June 30,
2000
Received in revised form:
June 30,
2000
Received:
March 16,
2000
Footnotes
☆This study was supported by the Chaim and Diana Rahamim grant for research in autoimmunity, Tel Aviv, Israel.
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
