SERUM IMMUNOGLOBULIN-E AND SUDDEN CARDIAC-ARREST DURING MYOCARDIAL-INFARCTION

Background: While studying the immunological response to acute myocard ial infarction (AMI) we noticed that patients who on admission had a h igh serum immunoglobulin E (IgE) level were less likely to die suddenl y. This observation seemed to deserve verification since atopic patien ts whose production of IgE was excessive had been reported to have dep ressed haemostatic platelet function and impaired thrombinogenesis. Me thods: We measured levels of serum IgE in 386 patients with AMI at the time of admission to the coronary care unit. Patients were divided in to two groups, depending on the presence (n = 55) or absence (n = 331) of sudden cardiac arrest. The two groups did not differ with respect to age, sex, or risk factors for coronary artery disease. Results: The mean level of serum IgE was significantly higher in the group without sudden cardiac arrest than in the group with this complication. In a separate study we found that high serum IgE levels were associated wit h delayed thrombin generation in the clotting blood of survivors of my ocardial infarction.Conclusion: Early determination of serum IgE level s might help to detect patients at risk of sudden cardiac arrest durin g myocardial infarction. Patients with high serum IgE levels might be protected against sudden cardiac death through the depression of clot formation because of the late appearance of thrombin in their coronary arteries.