Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome

Diana Ernst; Johan Westerbergh; Georgios Sogkas; Alexandra Jablonka; Gerrit Ahrenstorf; Reinhold Ernst Schmidt; Harald Heidecke; Lars Wallentin; Gabriela Riemekasten; Torsten Witte

doi:10.1038/s41598-019-51125-9

Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome

Diana Ernst^*, Johan Westerbergh, Georgios Sogkas, Alexandra Jablonka, Gerrit Ahrenstorf, Reinhold Ernst Schmidt, Harald Heidecke, Lars Wallentin, Gabriela Riemekasten, Torsten Witte

^*Corresponding author for this work

Clinic of Rheumatology

11 Citations (Scopus)

Abstract

Although several risk factors exist for acute coronary syndrome (ACS) no biomarkers for survival or risk of re-infarction have been validated. Previously, reduced serum concentrations of anti-ß₁AR Ab have been implicated in poorer ACS outcomes. This study further evaluates the prognostic implications of anti-ß₁AR-Ab levels at the time of ACS onset. Serum anti-ß₁AR Ab concentrations were measured in randomly selected patients from within the PLATO cohort. Stratification was performed according to ACS event: ST-elevation myocardial infarct (STEMI) vs. non-ST elevation myocardial infarct (NSTEMI). Antibody concentrations at ACS presentation were compared to 12-month all-cause and cardiovascular mortality, as well as 12-month re-infarction. Sub-analysis, stratifying for age and the correlation between antibody concentration and conventional cardiac risk-factors was subsequently performed. Serum anti-ß₁AR Ab concentrations were measured in 400/799 (50%) STEMI patients and 399 NSTEMI patients. Increasing anti-ß₁AR Ab concentrations were associated with STEMI (p = 0.001). Across all ACS patients, no associations between anti-ß₁AR Ab concentration and either all-cause cardiovascular death or myocardial re-infarction (p = 0.14) were evident. However among STEMI patients ≤60 years with anti-ß₁AR Ab concentration <median higher rates of re-infarction were observed, compared to those with anti-ß₁AR Ab concentrations > median (14/198 (7.1%) vs. 2/190 (1.1%)); p = 0.01). Similarly, the same sub-group demonstrated greater risk of cardiovascular death in year 1, including re-infarction and stroke (22/198 (11.1%) vs. 10/190 (5.3%); p = 0.017). ACS Patients ≤60 years, exhibiting lower concentrations of ß₁AR Ab carry a greater risk for early re-infarction and cardiovascular death. Large, prospective studies quantitatively assessing the prognostic relevance of Anti-ß₁AR Ab levels should be considered.

Original language	English
Article number	14552
Journal	Scientific Reports
Volume	9
Issue number	1
ISSN	2045-2322
DOIs	https://doi.org/10.1038/s41598-019-51125-9
Publication status	Published - 01.12.2019

Funding

The authors like to thank the laboratory staff of CellTrend for performing the ELISA tests. Diana Ernst is supported by a Government Grant Ellen-Schmidt 2018 of Hannover Medical School, Germany. Gerrit Ahrenstorf and Alexandra Jablonka were funded by the Young Academy Clinician/Scientist program of Hannover Medical School, Germany. The project was supported by KFO 250 of the German research foundation. Laboratory staff of CellTrend performed ELISA testing.

Research Areas and Centers

Academic Focus: Center for Infection and Inflammation Research (ZIEL)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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@article{72b3a0a7a6e8402c98e5824d754b92ea,

title = "Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome",

abstract = "Although several risk factors exist for acute coronary syndrome (ACS) no biomarkers for survival or risk of re-infarction have been validated. Previously, reduced serum concentrations of anti-{\ss}1AR Ab have been implicated in poorer ACS outcomes. This study further evaluates the prognostic implications of anti-{\ss}1AR-Ab levels at the time of ACS onset. Serum anti-{\ss}1AR Ab concentrations were measured in randomly selected patients from within the PLATO cohort. Stratification was performed according to ACS event: ST-elevation myocardial infarct (STEMI) vs. non-ST elevation myocardial infarct (NSTEMI). Antibody concentrations at ACS presentation were compared to 12-month all-cause and cardiovascular mortality, as well as 12-month re-infarction. Sub-analysis, stratifying for age and the correlation between antibody concentration and conventional cardiac risk-factors was subsequently performed. Serum anti-{\ss}1AR Ab concentrations were measured in 400/799 (50\%) STEMI patients and 399 NSTEMI patients. Increasing anti-{\ss}1AR Ab concentrations were associated with STEMI (p = 0.001). Across all ACS patients, no associations between anti-{\ss}1AR Ab concentration and either all-cause cardiovascular death or myocardial re-infarction (p = 0.14) were evident. However among STEMI patients ≤60 years with anti-{\ss}1AR Ab concentration 1AR Ab concentrations > median (14/198 (7.1\%) vs. 2/190 (1.1\%)); p = 0.01). Similarly, the same sub-group demonstrated greater risk of cardiovascular death in year 1, including re-infarction and stroke (22/198 (11.1\%) vs. 10/190 (5.3\%); p = 0.017). ACS Patients ≤60 years, exhibiting lower concentrations of {\ss}1AR Ab carry a greater risk for early re-infarction and cardiovascular death. Large, prospective studies quantitatively assessing the prognostic relevance of Anti-{\ss}1AR Ab levels should be considered.",

author = "Diana Ernst and Johan Westerbergh and Georgios Sogkas and Alexandra Jablonka and Gerrit Ahrenstorf and Schmidt, \{Reinhold Ernst\} and Harald Heidecke and Lars Wallentin and Gabriela Riemekasten and Torsten Witte",

note = "Funding Information: The authors like to thank the laboratory staff of CellTrend for performing the ELISA tests. Diana Ernst is supported by a Government Grant Ellen-Schmidt 2018 of Hannover Medical School, Germany. Gerrit Ahrenstorf and Alexandra Jablonka were funded by the Young Academy Clinician/Scientist program of Hannover Medical School, Germany. The project was supported by KFO 250 of the German research foundation. Laboratory staff of CellTrend performed ELISA testing. Publisher Copyright: {\textcopyright} 2019, The Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",

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language = "English",

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T1 - Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome

AU - Ernst, Diana

AU - Westerbergh, Johan

AU - Sogkas, Georgios

AU - Jablonka, Alexandra

AU - Ahrenstorf, Gerrit

AU - Schmidt, Reinhold Ernst

AU - Heidecke, Harald

AU - Wallentin, Lars

AU - Riemekasten, Gabriela

AU - Witte, Torsten

N1 - Funding Information: The authors like to thank the laboratory staff of CellTrend for performing the ELISA tests. Diana Ernst is supported by a Government Grant Ellen-Schmidt 2018 of Hannover Medical School, Germany. Gerrit Ahrenstorf and Alexandra Jablonka were funded by the Young Academy Clinician/Scientist program of Hannover Medical School, Germany. The project was supported by KFO 250 of the German research foundation. Laboratory staff of CellTrend performed ELISA testing. Publisher Copyright: © 2019, The Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Although several risk factors exist for acute coronary syndrome (ACS) no biomarkers for survival or risk of re-infarction have been validated. Previously, reduced serum concentrations of anti-ß1AR Ab have been implicated in poorer ACS outcomes. This study further evaluates the prognostic implications of anti-ß1AR-Ab levels at the time of ACS onset. Serum anti-ß1AR Ab concentrations were measured in randomly selected patients from within the PLATO cohort. Stratification was performed according to ACS event: ST-elevation myocardial infarct (STEMI) vs. non-ST elevation myocardial infarct (NSTEMI). Antibody concentrations at ACS presentation were compared to 12-month all-cause and cardiovascular mortality, as well as 12-month re-infarction. Sub-analysis, stratifying for age and the correlation between antibody concentration and conventional cardiac risk-factors was subsequently performed. Serum anti-ß1AR Ab concentrations were measured in 400/799 (50%) STEMI patients and 399 NSTEMI patients. Increasing anti-ß1AR Ab concentrations were associated with STEMI (p = 0.001). Across all ACS patients, no associations between anti-ß1AR Ab concentration and either all-cause cardiovascular death or myocardial re-infarction (p = 0.14) were evident. However among STEMI patients ≤60 years with anti-ß1AR Ab concentration 1AR Ab concentrations > median (14/198 (7.1%) vs. 2/190 (1.1%)); p = 0.01). Similarly, the same sub-group demonstrated greater risk of cardiovascular death in year 1, including re-infarction and stroke (22/198 (11.1%) vs. 10/190 (5.3%); p = 0.017). ACS Patients ≤60 years, exhibiting lower concentrations of ß1AR Ab carry a greater risk for early re-infarction and cardiovascular death. Large, prospective studies quantitatively assessing the prognostic relevance of Anti-ß1AR Ab levels should be considered.

AB - Although several risk factors exist for acute coronary syndrome (ACS) no biomarkers for survival or risk of re-infarction have been validated. Previously, reduced serum concentrations of anti-ß1AR Ab have been implicated in poorer ACS outcomes. This study further evaluates the prognostic implications of anti-ß1AR-Ab levels at the time of ACS onset. Serum anti-ß1AR Ab concentrations were measured in randomly selected patients from within the PLATO cohort. Stratification was performed according to ACS event: ST-elevation myocardial infarct (STEMI) vs. non-ST elevation myocardial infarct (NSTEMI). Antibody concentrations at ACS presentation were compared to 12-month all-cause and cardiovascular mortality, as well as 12-month re-infarction. Sub-analysis, stratifying for age and the correlation between antibody concentration and conventional cardiac risk-factors was subsequently performed. Serum anti-ß1AR Ab concentrations were measured in 400/799 (50%) STEMI patients and 399 NSTEMI patients. Increasing anti-ß1AR Ab concentrations were associated with STEMI (p = 0.001). Across all ACS patients, no associations between anti-ß1AR Ab concentration and either all-cause cardiovascular death or myocardial re-infarction (p = 0.14) were evident. However among STEMI patients ≤60 years with anti-ß1AR Ab concentration 1AR Ab concentrations > median (14/198 (7.1%) vs. 2/190 (1.1%)); p = 0.01). Similarly, the same sub-group demonstrated greater risk of cardiovascular death in year 1, including re-infarction and stroke (22/198 (11.1%) vs. 10/190 (5.3%); p = 0.017). ACS Patients ≤60 years, exhibiting lower concentrations of ß1AR Ab carry a greater risk for early re-infarction and cardiovascular death. Large, prospective studies quantitatively assessing the prognostic relevance of Anti-ß1AR Ab levels should be considered.

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JF - Scientific Reports

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ER -

Lowered anti-beta1 adrenergic receptor antibody concentrations may have prognostic significance in acute coronary syndrome

Abstract

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