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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References
- Quantification of coronary artery calcium using ultrafast computed tomography.J Am Coll Cardiol. 1990; 15: 827-832
- Calcification of coronary arteries.Radiology. 1995; 197: 779-783
- Coronary artery calcification.Radiology. 1968; 91: 109-115
- Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease.Circulation. 1996; 93: 898-904
- The pathogenesis of atherosclerosis.Nature. 1993; 362: 801-809
- Atheroma.Q J Med. 1999; 92: 57-59
- Atherosclerosis-related markers in systemic lupus erythematosus patients.Lupus. 1999; 8: 220-226
- Antibodies against cardiolipin and oxidatively modified LDL in 50-year-old men predict myocardial infarction.Arterioscler Thromb Vasc Biol. 1997; 17: 3159-3163
- Induction of primary antiphospholipid syndrome in mice by immunization with a human monoclonal anticardiolipin antibody (H-3).J Clin Invest. 1992; 89: 1558-1563
- Oxidized low-density lipoprotein (ox-LDL) but not LDL aggravates the manifestations of experimental antiphospholipid syndrome (APS).Clin Exp Immunol. 1997; 108: 227-233
- Electron beam computed tomographic coronary calcium score cutpoints and severity of associated angiographic lumen stenosis.J Am Coll Cardiol. 1997; 29: 1542-1548
- Coronary artery calcium in acute coronary syndromes. A comparative study of electron-beam computed tomography, coronary angiography, and intracoronary ultrasound in survivors of acute myocardial infarction and unstable angina.Circulation. 1997; 96: 1461-1469
- Comparison of electron beam computed tomography scanning and conventional risk factor assessment for the prediction of angiographic coronary artery disease.J Am Coll Cardiol. 1998; 32: 673-679
- Clinical significance of coronary artery calcification.Int Angiol. 1994; 13: 281-285
- The antiphospholipid (Hughes’) syndrome.Am J Reprod Immunol. 1999; 41: 113-116
- Atherosclerosis in LDL-receptor knockout mice is accelerated by immunization with anticardiolipin antibodies.Lupus. 1997; 6: 723-729
- Anti-cardiolipin antibodies in ischaemic heart disease.Clin Exp Immunol. 1988; 74: 254-257
- Anti-cardiolipin antibodies and risk of myocardial infarction in a prospective cohort of middle-aged men.Circulation. 1995; 91: 23-27
- Induction of early atherosclerosis in LDL-receptor-deficient mice immunized with beta2-glycoprotein I.Circulation. 1998; 98: 1108-1115
- Enhancement of atherosclerosis in beta-2-glycoprotein I-immunized apolipoprotein E-deficient mice.Pathobiology. 1999; 67: 19-25
- Immunolocalization of β2-glycoprotein I (apolipoprotein H) to human atherosclerotic plaques.Circulation. 1999; 99: 2227-2230
- High prevalence of anti-beta 2 glycoprotein I antibodies in patients with ischemic heart disease.Autoimmunity. 1999; 30: 93-98
- Patients with early-onset peripheral vascular disease have increased levels of autoantibodies against oxidized LDL.Arterioscler Thromb Vasc Biol. 1995; 15: 441-445
- LDL oxidation in patients with severe carotid atherosclerosis.Arterioscler Thromb. 1994; 14: 1892-1899
- Autoantibodies against oxidized low density lipoprotein in patients with angiographically verified coronary artery disease.Arterioscler Thromb Vasc Biol. 1999; 19: 23-27
- Autoantibody titers to oxidized low-density lipoprotein in patients with coronary atherosclerosis.Am Heart J. 1996; 131: 663-667
- Autoantibodies against low-density lipoproteins in older stroke patients.J Am Geriatr Soc. 1997; 45: 125-129
- Hyperimmunization of apo-E mice with homologous malondialdehyde low-density lipoprotein suppresses early atherogenesis.Atherosclerosis. 1998; 138: 147-152
- Effect of immunization with homologous LDL and oxidized LDL on early atherosclerosis in hypercholesterolemic rabbits.Arterioscler Thromb Vasc Biol. 1996; 16: 1074-1079
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.
