Anti-human skeletal muscle glycolipid antibodies in unstable angina

Background we studied whether the level of anti-skeletal muscle glycolipid antibodies (AGA), a marker of acute rejection in heart transplantation, may be associated with an adverse prognosis in unstable angina. Methods and Results The in-hospital evolution of 50 patients with unstable engine (Braunwald class III B) was assessed. We determined the incidence of death, myocardial infarction, and refractory angina, Blood was collected a t admission and 24 hours later for determination of AGA levels by enzyme-li nked immunosorbent assay. Twenty-three patients showed a decrease in the AG A level at 24 hours after admission. Ten in-hospital cardiac events occurre d in these patients (43.4%) as compared with 4 (14.8%) in the 27 patients w ho did not show a decrease (P = .025). In patients with previous myocardial infarction (n = 26), the AGA assay was a powerful predictor of outcome. In this subgroup, 66.6% of patients who had decreased AGA levels (8 of 12) ha d cardiac events as compared with 14.2% (2 of 14) of those who did not have that decrease (P = .001). Conclusions We conclude that a decrease of AGA levels 24 hours after admiss ion is associated with a complicated in-hospital course. This finding may p rovide new insights in the phenomenon of plaque instability involved in the development of acute coronary syndromes.