ANTIBODIES AGAINST ENDOTHELIAL-CELLS AND CARDIOLIPIN IN YOUNG-PATIENTS WITH PERIPHERAL ATHEROSCLEROTIC DISEASE

Objectives. To investigate the prevalence of anticardiolipin and antie ndothelial cell antibodies in patients operated on for atherosclerotic peripheral vascular disease before 50 years of age. The hypothesis to be tested was whether antibodies associated with an immune/inflammato ry damage to the vascular wall were associated also with early atheros clerosis, Design. A case-control study, Setting. Departments of surger y and an immunological research laboratory, and routine laboratories o f two tertiary referral hospitals. Subjects. All patients operated for atherosclerotic peripheral vascular disease before 50 years of age. S ixty-two patients (33 males, 29 females), and 67 age- and sex-matched controls participated. The diagnosis of atherosclerosis was made on th e basis of the clinical presentation and angiographic visualization of the diseased vasculature, Main outcome measures, Subjects were compar ed for the prevalence of anticardiolipin and antiendothelial cell anti bodies, altered serum lipoprotein levels, smoking, diabetes, hypertens ion, and signs of inflammation. Results, Antibodies against endothelia l cells and cardiolipin were found in 12.9 and 14.5% of the patients, respectively, which was higher than observed in the control group (P < 0.05). Sixty per cent of patients with antibodies were females, Conve ntional risk factors were more often noted in the patient group. Howev er, patients with antibodies against endothelial cell and/or cardiolip in had a lower prevalence of hyperlipidaemia/dyslipidaemia when compar ed to patients without these antibodies (P < 0.05), Conclusions, Antib odies against endothelial cells and cardiolipin are present in a subse t of patients with clinical and angiographic diagnosis of severe prema ture atherosclerotic peripheral vascular disease. The lower occurrence of hyperlipidaemia/dyslipidaemia in patients with autoantibodies, in comparison to patients without the antibodies, suggests that these ant ibodies have a role in vascular damage.