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心肌梗死年轻幸存者体内的心磷脂抗体:与心血管事件复发的关联

Antibodies to cardiolipin in young survivors of myocardial infarction: an association with recurrent cardiovascular events.

作者信息

Hamsten A, Norberg R, Björkholm M, de Faire U, Holm G

出版信息

Lancet. 1986 Jan 18;1(8473):113-6. doi: 10.1016/s0140-6736(86)92258-0.

Abstract

Antibodies to cardiolipin were measured in 62 survivors of myocardial infarction under age 45 at 3, 12, and 36 months after the acute event. 13 patients (21%) had raised anticardiolipin antibody levels on at least two of the three sampling occasions. Risk-factor profiles and coronary angiographic findings did not differ between the anticardiolipin-positive group and the rest of the patients. No correlation was found between cardiolipin and anti-DNA antibody levels. 8 of the 13 patients with raised anticardiolipin antibody levels experienced additional cardiovascular events during a follow-up of 36-64 months after the first myocardial infarction: cerebral infarction developed in 2, arterial occlusion of the lower limb in 2, new myocardial infarction in 3, pulmonary emboli in 1, and deep-vein thrombosis in 1. These 8 patients had cardiolipin antibody titres of 5 times the mean for voluntary blood donors. Antibodies to cardiolipin are common in young post-infarction patients and should be interpreted as markers of high risk for recurrent cardiovascular events.

摘要

在急性心肌梗死后3个月、12个月和36个月时,对62名年龄在45岁以下的心肌梗死幸存者检测了抗心磷脂抗体。13名患者(21%)在三次采样中的至少两次检测中抗心磷脂抗体水平升高。抗心磷脂抗体阳性组与其他患者在危险因素概况和冠状动脉造影结果方面并无差异。未发现心磷脂抗体水平与抗DNA抗体水平之间存在相关性。在13名抗心磷脂抗体水平升高的患者中,有8名在首次心肌梗死后36 - 64个月的随访期间发生了额外的心血管事件:2例发生脑梗死,2例发生下肢动脉闭塞,3例发生新的心肌梗死,1例发生肺栓塞,1例发生深静脉血栓形成。这8名患者的心磷脂抗体滴度是自愿献血者平均滴度的5倍。抗心磷脂抗体在年轻的心肌梗死后患者中很常见,应被视为复发性心血管事件高风险的标志物。

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