Prevalence of β2 Glycoprotein I Dependent Anticardiolipin Antibodies in Acute Myocardial Infarction

Pazhanivel, M (2006) Prevalence of β2 Glycoprotein I Dependent Anticardiolipin Antibodies in Acute Myocardial Infarction. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Coronary artery disease is one of the greatest killer diseases of mankind. It is the leading cause of death and disability in developed nations and is increasing rapidly in the developing world. The World Health Organization has drawn attention to the fact that coronary heart disease is our modern epidemic. The prevalence of coronary artery disease has progressively increased in India during the last half century. An aggressive lookout for the evaluation of coronary artery disease is required for some special risk factors apart from the conventional risk factors. The pathophysiological basis of acute coronary syndromes relies on the existence of vulnerable atherothrombotic plaques within the coronary arteries. Newer inflammatory and immunological mechanisms are emerging for the initiation and progression of atherosclerotic lesions. Anticardiolipin antibodies are a heterogenous family of autoantibodies found to play an important role in the patho physiology of atherosclerosis. They have been implicated as one of the most common acquired protein defects causing thrombosis. These antibodies have been associated with several forms of cardiovascular diseases such as myocardial infarction, stroke, carotid stenosis, and so on. In India, a few studies have been conducted regarding the prevalence and incidence of the anticardiolipin antibodies. AIM OF THE STUDY: 1. To find out the prevalence of beta2-glycoprotein I dependent anticardiolipin antibodies (β2GPI) of isotype IgG and IgM in patients with ST segment elevation myocardial infarction who were 55 years or younger. 2. To find out the correlation between the conventional cardiovascular risk factors and anticardiolipin antibodies. MATERIALS AND METHODS: The present study was an observational study conducted on a total of 63 patients admitted into the intensive coronary care unit in the cardiology department at Govt. Stanley Medical College Hospital, Chennai. The period of study was from January 2005 to January 2006. Selection criteria: Patients aged 55 years or younger, of either sex, who fulfilled the World Health Organization criteria for the diagnosis of acute myocardial infarction, were included in the study. We decided to have a cut off age of 55 for patients enrolled in the study group, since the prevalence of positive ELISA antiphospholipid tests increases with age. Further more, the prevalence of anticardiolipin antibodies in apparently healthy elderly individuals aged more than 65 years ranged between 12-52%. Equal number of age and sex matched controls were considered for comparison with our cases. By a thorough history taking, the presence of conventional cardiovascular risk factors such as hypertension, smoking, dyslipidemia, diabetes mellitus, and family history of premature coronary artery disease were obtained. Blood samples were taken immediately after hospitalization to determine the presence of β2-glycoprotein I dependent anticardiolipin antibodies. Laboratory recommendations regarding the transport of samples were strictly followed. The samples were analyzed at the Dept. of Immunology, Govt. Stanley Medical College, Chennai. RESULTS: In the present study, among the 63 cases, the age distribution ranged from 29-55 years, with a mean age of 44 years. Since age is a major risk factor for coronary artery disease (age>45 for males and >55 for females), the cases were subdivided into two groups with 45 as the line of demarcation between them. Acute myocardial infarction occurred predominantly in males when compared to females in our study. CONCLUSION: The prevalence of β2glycoprotein I-dependent anticardiolipin antibodies was found to be 27%. IgG 2glycoprotein I-dependent anticardiolipin antibodies was the most relevant isotype associated with acute myocardial infarction. Hypertensives had a higher frequency of β2 glycoprotein I dependent anticardiolipin antibodies. β2 glycoprotein I dependent anticardiolipin antibodies did not show a significant association with other conventional risk factors considered. (diabetes mellitus, smoking, and family history of premature coronary artery disease).

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prevalence ; β2 Glycoprotein I Dependent ; Anticardiolipin Antibodies ; Acute Myocardial Infarction
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 23 Mar 2018 03:48
Last Modified: 24 Mar 2018 04:08

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