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Low levels of IgG autoantibodies against the apolipoprotein B antigen p210 increases the risk of cardiovascular death after carotid endarterectomy.
Atherosclerosis. 2015 Apr; 239(2):289-94.A

Abstract

OBJECTIVES

Autoimmune responses against oxidized-LDL (oxLDL) have been suggested to modulate inflammation in atherosclerosis. Previous studies showed an association between autoantibodies against the apolipoprotein B (apoB) p210 antigen and a lower risk of cardiovascular (CV) events. In the present study we investigated if autoantibodies against p210 at the time of carotid endarterectomy (CEA) predict risk for future CV events.

METHODS

Native (nat) and malondialdehyde (MDA)-modified apoB p210 autoantibodies (IgM-p210nat, IgG-p210nat, IgM-p210MDA and IgG-p210MDA) were analyzed by ELISA from plasma samples of 351 patients at the time they underwent CEA. The incidence of postoperative CV events was assessed using national registers.

RESULTS

A total of 52 non-fatal and 15 fatal CV events were registered during the follow-up period (35.1 ± 16.7 months). Patients who suffered from a fatal CV event had significantly lower plasma levels of IgG-p210nat and IgG-p210MDA. Kaplan-Meier curves of event-free survival showed increased CV mortality in patients with levels of IgG-p210nat and IgG-p210MDA below the median (Log Rank 7.813, p .005 and 9.105, p .003 respectively). The association between low levels of p210 IgG and fatal post-operative CV events remained significant when adjusting for age, sex, total cholesterol, HDL cholesterol, smoking habits and hypertension in a Cox Proportional Hazard model (hazard ratios (HR) IgG-p210nat below median: HR 6.7 (95% C.I. 1.5-30.6, p .013) and IgG-p210MDA below median: HR 7.8 (95% C.I. 1.7-35.5, p .008).

CONCLUSIONS

The present findings support the notion that autoantibodies against LDL antigens are involved in the atherosclerotic disease process and suggest that CEA patients with low levels of IgG-p210nat and IgG-p210MDA have an increased risk of post-operative CV death.

Authors+Show Affiliations

Vascular Center Malmö, Skåne University Hospital, Malmö, Sweden. Electronic address: giuseppe.asciutto@med.lu.se.Vascular Center Malmö, Skåne University Hospital, Malmö, Sweden.Experimental Cardiovascular Research Unit, Clinical Research Center, Dept. of Clinical Sciences Malmö, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden.Experimental Cardiovascular Research Unit, Clinical Research Center, Dept. of Clinical Sciences Malmö, Lund University, Malmö, Sweden.Experimental Cardiovascular Research Unit, Clinical Research Center, Dept. of Clinical Sciences Malmö, Lund University, Malmö, Sweden.Experimental Cardiovascular Research Unit, Clinical Research Center, Dept. of Clinical Sciences Malmö, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden.Experimental Cardiovascular Research Unit, Clinical Research Center, Dept. of Clinical Sciences Malmö, Lund University, Malmö, Sweden.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25682025

Citation

Asciutto, Giuseppe, et al. "Low Levels of IgG Autoantibodies Against the Apolipoprotein B Antigen P210 Increases the Risk of Cardiovascular Death After Carotid Endarterectomy." Atherosclerosis, vol. 239, no. 2, 2015, pp. 289-94.
Asciutto G, Dias NV, Edsfeldt A, et al. Low levels of IgG autoantibodies against the apolipoprotein B antigen p210 increases the risk of cardiovascular death after carotid endarterectomy. Atherosclerosis. 2015;239(2):289-94.
Asciutto, G., Dias, N. V., Edsfeldt, A., Alm, R., Fredrikson, G. N., Gonçalves, I., & Nilsson, J. (2015). Low levels of IgG autoantibodies against the apolipoprotein B antigen p210 increases the risk of cardiovascular death after carotid endarterectomy. Atherosclerosis, 239(2), 289-94. https://doi.org/10.1016/j.atherosclerosis.2015.01.023
Asciutto G, et al. Low Levels of IgG Autoantibodies Against the Apolipoprotein B Antigen P210 Increases the Risk of Cardiovascular Death After Carotid Endarterectomy. Atherosclerosis. 2015;239(2):289-94. PubMed PMID: 25682025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low levels of IgG autoantibodies against the apolipoprotein B antigen p210 increases the risk of cardiovascular death after carotid endarterectomy. AU - Asciutto,Giuseppe, AU - Dias,Nuno V, AU - Edsfeldt,Andreas, AU - Alm,Ragnar, AU - Fredrikson,Gunilla N, AU - Gonçalves,Isabel, AU - Nilsson,Jan, Y1 - 2015/01/28/ PY - 2014/11/14/received PY - 2015/01/04/revised PY - 2015/01/14/accepted PY - 2015/2/16/entrez PY - 2015/2/16/pubmed PY - 2015/12/15/medline KW - Apolipoprotein B KW - Autoantibodies KW - Cardiovascular events KW - Carotid stenosis SP - 289 EP - 94 JF - Atherosclerosis JO - Atherosclerosis VL - 239 IS - 2 N2 - OBJECTIVES: Autoimmune responses against oxidized-LDL (oxLDL) have been suggested to modulate inflammation in atherosclerosis. Previous studies showed an association between autoantibodies against the apolipoprotein B (apoB) p210 antigen and a lower risk of cardiovascular (CV) events. In the present study we investigated if autoantibodies against p210 at the time of carotid endarterectomy (CEA) predict risk for future CV events. METHODS: Native (nat) and malondialdehyde (MDA)-modified apoB p210 autoantibodies (IgM-p210nat, IgG-p210nat, IgM-p210MDA and IgG-p210MDA) were analyzed by ELISA from plasma samples of 351 patients at the time they underwent CEA. The incidence of postoperative CV events was assessed using national registers. RESULTS: A total of 52 non-fatal and 15 fatal CV events were registered during the follow-up period (35.1 ± 16.7 months). Patients who suffered from a fatal CV event had significantly lower plasma levels of IgG-p210nat and IgG-p210MDA. Kaplan-Meier curves of event-free survival showed increased CV mortality in patients with levels of IgG-p210nat and IgG-p210MDA below the median (Log Rank 7.813, p .005 and 9.105, p .003 respectively). The association between low levels of p210 IgG and fatal post-operative CV events remained significant when adjusting for age, sex, total cholesterol, HDL cholesterol, smoking habits and hypertension in a Cox Proportional Hazard model (hazard ratios (HR) IgG-p210nat below median: HR 6.7 (95% C.I. 1.5-30.6, p .013) and IgG-p210MDA below median: HR 7.8 (95% C.I. 1.7-35.5, p .008). CONCLUSIONS: The present findings support the notion that autoantibodies against LDL antigens are involved in the atherosclerotic disease process and suggest that CEA patients with low levels of IgG-p210nat and IgG-p210MDA have an increased risk of post-operative CV death. SN - 1879-1484 UR - https://www.unboundmedicine.com/medline/citation/25682025/Low_levels_of_IgG_autoantibodies_against_the_apolipoprotein_B_antigen_p210_increases_the_risk_of_cardiovascular_death_after_carotid_endarterectomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9150(15)00057-X DB - PRIME DP - Unbound Medicine ER -