AUTHOR=Ernst Diana , Widera Christian , Weiberg Desiree , Derlin Thorsten , Ahrenstorf Gerrit , Sogkas Georgios , Jablonka Alexandra , Schmidt Reinhold E. , Witte Torsten , Heidecke Harald , Riemekasten Gabriela 

TITLE=Beta-1-Adrenergic Receptor Antibodies in Acute Coronary Syndrome: Is Less Sometimes More?

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=5

YEAR=2018

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2018.00170

DOI=10.3389/fcvm.2018.00170

ISSN=2297-055X

ABSTRACT=<p><bold>Background:</bold> Anti-beta-1-adrenergic receptor antibodies (anti-β<sub>1</sub>AR Ab) are associated with ischemic cardiomyopathies (ICM). Evidence continues to emerge supporting an autoimmune component to various cardiac diseases. This study compares anti-β<sub>1</sub>AR Ab concentrations in patients with different entities of acute coronary syndromes (ACS) to asymptomatic non-ACS patients with positron-emission computed tomography (PET/CT)-proven atherosclerosis, and healthy controls.</p><p><bold>Methods:</bold> Serum anti-β<sub>1</sub>AR Ab IgG concentrations were measured in 212 ACS patients, 100 atherosclerosis patients, and 62 controls using ELISA. All ACS patients underwent coronary angiography. All 374 patients participating completed a structured questionnaire regarding traditional cardiovascular risk factors. ACS patients were followed up for 6 months.</p><p><bold>Results:</bold> Patients with ACS exhibited lower anti-β<sub>1</sub>AR Ab levels compared to patients with atherosclerosis or healthy controls (both <italic>p</italic> &lt; 0.001). No differences in the ab levels were evident between healthy controls and patients with atherosclerosis. In the ACS groups, lower concentrations were found in patients with ST-elevation myocardial infarction (STEMI) (0.67 μg/ml) compared to patients with angina pectoris (AP) and non-ST elevation myocardial infarction (NSTEMI) (both 0.76 μg/ml, <italic>p</italic> = 0.008). Anti-β<sub>1</sub>AR Ab levels ≤ 0.772 μg/ml were predictive for death and reinfarction (AUC 0.77, <italic>p</italic> = 0.006). No significant correlations between anti-β<sub>1</sub>AR Ab levels and atherosclerotic burden or traditional cardiovascular risk factors were identified.</p><p><bold>Conclusions:</bold> Lower anti-β<sub>1</sub>AR Ab concentrations appear to characterize ACS phenotypes and could serve as diagnostic and prognostic markers independent from traditional risk factors for atheroscle. The prognostic predictive value of anti-β<sub>1</sub>AR Ab in ACS remains to be confirmed in larger studies.</p>