ANTICARDIOLIPIN ANTIBODIES AND ACUTE MYOCARDIAL-INFARCTION IN NONSYSTEMIC LUPUS ERYTHMATOSUS PATIENTS - A CONTROLLED PROSPECTIVE-STUDY

PURPOSE: To examine the prevalence of anticardiolipin antibodies (ACLA ) in relatively young patients with acute myocardial infarction (MI) a nd their role in subsequent coronary and thromboembolic events in the post-MI period. PATIENTS AND METHODS: In 124 relatively young survivor s (aged 65 or younger) of acute MI, ACLA were measured in a controlled prospective study on admission and 3 months later. Myocardial reinfar ction and thromboembolic events during a mean follow-up period of 19 /- 3 months were diagnosed by standard tests. RESULTS: Seventeen (14%) of the 124 patients were ACLA positive (either IgM or IgG) upon admis sion compared with 2 out of 76 (3%) of the control group matched for a ge and coronary risk factors (P <0.01). The levels of ACLA remained un changed in all but 1 patient 3 months later. During the follow-up peri od the rate of thromboembolic events and myocardial reinfarction was s ignificantly higher in the ACLA-positive patients as compared with the ACLA-negative group: 41% versus 4% (P <0.0001) and 35% versus 10% (P <0.05), respectively. Using logistic regression, high titer of ACLA wa s found to be the only independent risk factor for subsequent thromboe mbolic events or myocardial reinfarction after acute MI. CONCLUSIONS: High prevalence of ACLA was found in relatively young survivors of acu te MI. The presence of ACLA is a marker for increased risk of subseque nt myocardial reinfarction and thromboembolic events after acute MI.