Scientists discover how antibodies linked to heart attacks

In a recent study, researchers found levels of antiphospholipid antibodies, which are linked to rheumatic diseases, are also elevated in myocardial infarction without any autoimmune co-morbidity.

The study is from Karolinska Institutet.

Antiphospholipid antibodies (aPL) are a group of antibodies that target endogenous tissue, including the fat molecule cardiolipin and the plasma protein ?2glycoprotein-I.

Cardiolipin is found in the membranes of blood vessel and blood platelet cells, whereas ?2glycoprotein-I is found in the blood and is thought to help the body rid itself of dead cells.

The antibodies are common in rheumatic diseases such as SLE and increase the risk of blood clots.

Antiphospholipid syndrome (APS) is an autoimmune condition characterised by recurrent blood clots and/or pregnancy morbidities together with chronically elevated levels of antiphospholipid antibodies.

It is unknown how common the antibodies are in patients with myocardial infarction but without any autoimmune co-morbidity.

Previous studies have been small and the antibody measurement flawed.

The study involved 800 patients from 17 Swedish hospitals who had suffered their first myocardial infarction and as many matched healthy controls.

Their blood was then analyzed 6 to 10 weeks after the infarction for three different antiphospholipid antibody types: immunoglobulin G (IgG), M (IgM) and A (IgA).

It was found that eleven per cent of the patients had antiphospholipid antibodies against both cardiolipin and ?2glycoprotein-I, which was ten times more than the controls.

However, the increase was only found in the IgG antibodies, the type that is considered most associated with blood clots.

The measurement was done on one single occasion, so it is not impossible that it reflects a temporary reaction to the infarction.

However, if the levels of antiphospholipid antibodies remained elevated for a further three months, by definition these patients have APS.

In which case they should, according to current recommendations, be prescribed lifelong treatment with the anticoagulant warfarin, which reduces the risk of new blood clots.

This would change the prevailing guidelines for the investigation and treatment of heart attacks.

The finding is published in The Annals of Internal Medicine reports.

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Source: The Annals of Internal Medicine reports.