High prevalence of anti-beta 2 glycoprotein I antibodies in patients with ischemic heart disease

Ischemic cardiac manifestations have been reported in a various percentage of patients with anti-phospholipid antibodies. As concerns the relationship between anti-beta 2 glycoprotein I antibodies (anti-beta 2-GPI) and ischem ic heart disease (IHD), it was investigated in only one coronary primary pr evention study, We investigated the prevalence of anti-beta 2-GPI in a well characterized group of patients with different clinical manifestation of I HD, Sera from 37 patients (mean age 62.7 +/- 9.9) with IHD (20 with unstabl e angina-UA and 17 with effort angina-EA) and from 40 healthy subjects, mat ched for age and sex, were tested for the presence of IgG and IgM anti-beta 2-GPI using an ELISA technique. Eleven/37 patients (29.7%) resulted positi ve for anti-beta 2-GPI, A positivity for IgG anti-beta 2-GPI was found in 1 0 patients, 1 patient was positive for IgM and 1 for both isotypes, The pre valence of anti-beta 2-GPI in the control group resulted significantly lowe r (2.5%; p < 0.005) than in patients with IHD, Positivity for anti-beta 2-G PI was found in 9/20 (45%) patients with UA and only in 2/17 patients (11.8 %) with EA (p = 0.0365), IgG anti-beta 2 -GPI levels (median 7.7 U/ml, rang e 2.6-24.1) mere significantly higher in patients with UA compared to patie nts with EA (median 4.6 U/ml, range 2.3-11.5; p = 0.02) and controls (media n 3.15 U/ml, range 2.3-9.0; p < 0.0001); also IgM levels resulted higher in patients with unstable angina. A positivity for anti-beta 2-GPI was observ ed in 4/13 patients (30.8%) with a previous myocardial infarction (MI) and in 7/24 (29.2%) patients without a previous MT, Our findings suggest that a nti-beta 2-GPI could represent an expression of the T-cell activation detec table in patients with unstable angina. The lack of a significant differenc e in the prevalence of these antibodies in patients with or without a previ ous MI suggests that anti-beta(2)-GPI are not induced by tissue necrosis.