Antiphospholipid antibodies and sub-clinical atherosclerosis in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort
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Objective and design
Antiphospholipid antibodies (APA) have been associated with clinical cardiovascular disease, but it remains unclear whether APA are associated with sub-clinical atherosclerosis. This study examined the relationship between APA and sub-clinical atherosclerosis, measured as coronary artery calcification (CAC), in participants from the prospective Coronary Artery Risk Development in Young Adults (CARDIA) Study.
Subjects and method
2,203 black and white participants with sera available from the CARDIA year 7 examination and CAC measured by computed tomography at years 15 or 20 were selected.
Anti-β2-glycoprotein I (anti-β2-GPI) immunoglobulin (Ig) M, IgG, and IgA were positive in 7.0, 1.4, and 1.8 % of participants, respectively; anti-cardiolipin (aCL) IgM and IgG were positive in 1.5 and 1.0 %, respectively. 9.5 % of participants had CAC score >0 at year 15. Anti-β2-GPI IgM, IgG, IgA, and aCL IgG positivity were associated with CAC >0 at year 15 after adjustment for traditional cardiovascular risk factors; [odds ratios (95 % confidence intervals) were 1.7 (1.0, 3.1), 6.4 (2.4, 16.8), 5.6 (2.3, 13.2), and 5.1 (1.4, 18.6), respectively]. Anti-β2-GPI IgG was associated with year 20 CAC >0, and anti-β2-GPI IgA and aCL IgG were marginally associated.
These findings indicate that APA positivity during young adulthood is a risk factor for subsequent sub-clinical atherosclerosis and might play a role in the pathogenesis of atherosclerosis.
KeywordsAntiphospholipid antibodies Cardiovascular disease Coronary atherosclerosis Coronary artery calcification EBCT MDCT
- 5.Sherer Y, Tenenbaum A, Praprotnik S, Shemesh J, Blank M, Fisman EZ, Harats D, George J, Levy Y, Peter JB, et al. Coronary artery disease but not coronary calcification is associated with elevated levels of cardiolipin, beta-2-glycoprotein-I, and oxidized LDL antibodies. Cardiology. 2001;95(1):20–4.PubMedCrossRefGoogle Scholar
- 15.Ames PR, Margarita A, Delgado Alves J, Tommasino C, Iannaccone L, Brancaccio V. Anticardiolipin antibody titre and plasma homocysteine level independently predict intima media thickness of carotid arteries in subjects with idiopathic antiphospholipid antibodies. Lupus. 2002;11(4):208–14.Google Scholar
- 16.Dropinski J, Szczeklik W, Rubis P, Sydor WJ. Anti-phospholipid antibodies and carotid-artery intima-media thickness in young survivors of myocardial infarction. Med Sci Monit. 2003;9(4):BR105–9.Google Scholar
- 20.Plazak W, Pasowicz M, Kostkiewicz M, Podolec J, Tomkiewicz-Pajak L, Musial J, Podolec P. Influence of chronic inflammation and autoimmunity on coronary calcifications and myocardial perfusion defects in systemic lupus erythematosus patients. Inflamm Res. 2011;60(10):973–80.PubMedCrossRefGoogle Scholar
- 21.Cutter GR, Burke GL, Dyer AR, Friedman GD, Hilner JE, Hughes GH, Hulley SB, Jacobs DR, Jr., Liu K, Manolio TA, et al. Cardiovascular risk factors in young adults. The CARDIA baseline monograph. Control Clin Trials. 1991;12(1 Suppl):1S–77S.Google Scholar
- 22.Fanopoulos D, Teodorescu MR, Varga J, Teodorescu M. High frequency of abnormal levels of IgA anti-beta2-glycoprotein I antibodies in patients with systemic lupus erythematosus: relationship with antiphospholipid syndrome. J Rheumatol. 1998;25(4):675–80.Google Scholar
- 23.Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, De Groot PG, Koike T, Meroni PL, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4(2):295–306.PubMedCrossRefGoogle Scholar
- 29.Wilkins JT, Gidding S, Liu K, Ning H, Polak JF, Lloyd-Jones DM. Associations between a parental history of premature cardiovascular disease and coronary artery calcium and carotid intima-media thickness: the Coronary Artery Risk Development In Young Adults (CARDIA) study. Eur J Prev Cardiol. 2012. doi:10.1177/2047487312462801.
- 31.Sherer Y, Gerli R, Gilburd B, Bartoloni Bocci E, Vaudo G, Mannarino E, Shoenfeld Y. Thickened carotid artery intima-media in rheumatoid arthritis is associated with elevated anticardiolipin antibodies. Lupus. 2007;16(4):259–64.Google Scholar