THE SIGNIFICANCE OF ANTICARDIOLIPIN ANTIBODIES AND ANTI-HEART MUSCLE ANTIBODIES FOR THE DIAGNOSIS OF POSTPERICARDIOTOMY-SYNDROME

Postpericardiotomy syndrome (PPS) is a frequent complication after car diac surgery. In a recent study, elevated anticardiolipin antibody (AC LA) titres were observed in patients with PPS. The value of anti-heart muscle antibodies (AHA) for the diagnosis of PPS remains controversia l. Therefore, a prospective double-blind study was performed to test t he sensitivity and specificity of ACLA and AHA for the diagnosis of PP S. ACLA titres (ELISA) and AHA, elevated by immunofluorescence, the cl inical course and routine laboratory parameters were assessed in 57 pa tients before and after elective cardiac surgery. ACLA increased and A HA first appeared after surgery in patients with and without PPS. The sensitivities of a greater than or equal to 1.5-fold increase in IgM-A CLA titres, of a greater than or equal to 2-fold increase in IgG-ACLA titres and of the occurrence of AHA greater than or equal to 2+ for th e diagnosis of PPS were 60%, 20% and 20%. The respective specificities were 43%, 79% and 85%. Thus, after cardiac surgery, increased ACLA ti tres and the occurrence of AHA, as assessed by immunofluorescence, may only contribute to the diagnosis of PPS to a limited extent.