Veres Amarilla, Füst George, Smieja Marek, McQueen Matthew, Horváth Anna, Yi Qilong, Bíró Adrienn, Pogue Janice, Romics László, Karádi István, Singh Mahavir, Gnarpe Judy, Prohászka Zoltán, Yusuf Salim
Third Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Circulation. 2002 Nov 26;106(22):2775-80. doi: 10.1161/01.cir.0000038890.39298.8d.
Several recent studies have indicated an association between key inflammatory mediators and atherosclerotic diseases. We evaluated whether high levels of antibodies against heat shock proteins and cholesterol (ACHA) predicted cardiovascular (CV) events.
We used blood samples from the Heart Outcomes Prevention Evaluation (HOPE) study to conduct a nested case-control study of 386 cases with CV events and 386 age- and sex-matched HOPE study controls without events. We explored the relationship between anti-hsp antibodies, ACHA, and subsequent outcomes (incident myocardial infarction, stroke, or CV death) during a mean follow-up of 4.5 years using conditional logistic regression. High levels of anti-hsp65 antibodies (> or =90th percentile) predicted CV events (OR, 2.1; 95% CI, 1.2 to 3.9, P=0.01). Anti-hsp60 antibodies did not predict any event type, whereas incident stroke developed significantly less frequently in patients with high ACHA levels. Anti-hsp antibodies and ACHA did not correlate with inflammatory (fibrinogen, C-reactive protein, interleukin-6, intracellular adhesion molecule-1) or infectious markers (C pneumoniae or cytomegalovirus antibodies). Anti-hsp65 antibodies (> or =90th percentile) and fibrinogen (highest tertile) had a strong joint effect: patients with high concentrations of both had more CV events (OR, 5.5; 95% CI, 1.8 to 17.5, P=0.004) than patients with low levels of both. A similar joint effect (OR, 2.7; 95% CI, 1.3 to 5.7, P=0.01) was found for high levels of anti-hsp65 and presence of cytomegalovirus antibodies.
Serum antibodies to hsp65 were associated with subsequent CV events in this study of high-risk patients, independent of conventional cardiovascular risk factors and other inflammatory markers.
最近的几项研究表明关键炎症介质与动脉粥样硬化性疾病之间存在关联。我们评估了抗热休克蛋白和胆固醇抗体（ACHA）水平升高是否能预测心血管（CV）事件。
我们使用心脏结局预防评估（HOPE）研究中的血样进行了一项巢式病例对照研究，其中有386例发生CV事件的患者以及386例年龄和性别匹配的未发生事件的HOPE研究对照。我们使用条件逻辑回归分析，在平均4.5年的随访期间，探讨了抗热休克蛋白抗体、ACHA与后续结局（新发心肌梗死、中风或CV死亡）之间的关系。抗热休克蛋白65抗体水平高（≥第90百分位数）可预测CV事件（比值比[OR]，2.1；95%置信区间[CI]，1.2至3.9，P = 0.01）。抗热休克蛋白60抗体不能预测任何事件类型，而ACHA水平高的患者发生中风的频率显著较低。抗热休克蛋白抗体和ACHA与炎症标志物（纤维蛋白原、C反应蛋白、白细胞介素-6、细胞间黏附分子-1）或感染标志物（肺炎衣原体或巨细胞病毒抗体）无关。抗热休克蛋白65抗体（≥第90百分位数）和纤维蛋白原（最高三分位数）有很强的联合效应：两者浓度都高的患者比两者水平都低的患者发生CV事件更多（OR，5.5；95%CI，1.8至17.5，P = 0.004）。抗热休克蛋白65水平高和存在巨细胞病毒抗体也有类似的联合效应（OR，2.7；95%CI，1.3至5.7，P = 0.01）。
在这项针对高危患者的研究中，抗热休克蛋白65的血清抗体与后续CV事件相关，独立于传统心血管危险因素和其他炎症标志物。
