IgM antibodies against phosphorylcholine measured early after acute ST-elevation myocardial infarction in relation to atherosclerotic disease burden and long-term clinical outcome

• Published in: PloS one Vol. 14; no. 4; p. e0215640
• Main Authors: Knudsen, Eva Cecilie, Seljeflot, Ingebjørg, Aksnes, Tonje Amb, Eritsland, Jan, Arnesen, Harald, Andersen, Geir Øystein
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.04.2019; PLOS; Public Library of Science (PLoS)
• Subjects: Acute coronary syndromes; Aged; Antibodies; Antibodies, Anti-Idiotypic - blood; Antibodies, Anti-Idiotypic - immunology; Arteriosclerosis; Atherosclerosis; Atherosclerosis - blood; Atherosclerosis - diagnosis; Blood vessels; Cardiac patients; Cardiology; Cardiovascular disease; Care and treatment; Cerebral infarction; Congestive heart failure; Coronary artery; Coronary artery disease; Coronary Artery Disease - blood; Coronary Artery Disease - diagnosis; Coronary heart disease; Coronary vessels; Diabetes mellitus; Female; Follow-Up Studies; Glucose; Health aspects; Heart attack; Heart attacks; Heart failure; Hospital admission and discharge; Hospitals; Humans; Immunoglobulin M; Immunoglobulin M - blood; Immunoglobulin M - immunology; Immunoglobulins; Inflammatory diseases; Ischemia; Male; Medical research; Middle Aged; Mortality; Myocardial infarction; Outcome Assessment, Health Care; Oxidation; Patient outcomes; Patients; Percutaneous Coronary Intervention - methods; Phosphorylcholine; Phosphorylcholine - immunology; Prognosis; Serum levels; ST Elevation Myocardial Infarction - blood; ST Elevation Myocardial Infarction - diagnosis; ST Elevation Myocardial Infarction - surgery; Studies; Syntax; Norway; Sweden
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0215640

Studies have reported an association between low levels of natural immunoglobulin M antibodies against phosphorylcholine(IgM anti-PC) and worse prognosis in patients with coronary artery disease (CAD). The aims of the present study were, in patients with ST-elevation myocardial infarction (STEMI); 1) to compare serum levels of IgM anti-PC measured acutely and after 3 months; 2) to study an association between levels of IgM anti-PC and the severity ofCAD, and; 3) to investigate whether IgM anti-PC levels are associated with long-term clinical outcome. A total of 213 patients without known diabetes (median age 59 years) with a PCI treated STEMI were enrolled. IgM anti-PC was measured in-hospital and after 3 months. Median follow-up time was 6.5 years (all-cause mortality, non-fatal myocardial re-infarction, recurrent ischemia causing hospital admission, heart failure and stroke). The severity of CAD was evaluated by coronary angiograms and patients were classified as having single- or multi-vessel disease and by SYNTAX score (SXscore). IgM anti-PC levels were stable over time when measured acutely and after 3 months. Patients with multi-vessel disease and high SXscore had significantly lower levels of IgM anti-PC in the acute phase of STEMI. Low levels of IgM anti-PC (the 25 percentile) measured acutely were associated with a 2-fold increase in the odds of having multi-vessel disease (adjusted OR 2.28 (95% CI 1.17, 4.44), p = 0.016), but not with high SXscore (Crude OR 2.20 (95% CI 0.96, 5.07), p = 0.06). Fifty-three patients experienced a new clinical event during long-term follow-up. Low levels of IgM anti PC were not associated with worse prognosis, (crude HR 1.54 (0.87-2.76), p = 0.14). STEMI patients with multi-vessel disease or high SXscore had significantly lower levels of IgM anti-PC in the acute phase and low levels were associated with multi-vessel disease, but not with worse clinical outcome during long-term follow-up.