Purpose: IgM antibodies against phosphorylcholine (anti-PC) reduce the uptake of oxidized LDL and inhibit the effect of-inflammatory phospholipids, thereby exerting an atheroprotective effect. Prevoius studies have shown that low anti-PC serum levels increase the risk of cardiovascular (CV) events. The aim of the present study was to investigate the association of low levels of anti-PC with the incidence of CV events and the progression of intima media thickness (IMT) in a large cohort of individuals at high risk of cardiovascular diseases contained in the IMPROVE study, a prospective multicenter European study. Methods: 3711 subjects (age 54-79) with at least three established cardiovascular risk factors at enrollment. Serum levels of anti-PC were measured at baseline on all the study participants by ELISA (CV Define, Athera Biotechnologies AB, Stockholm Sweden). Carotid ultrasound investigations were performed at baseline and after 15 and 30 months of follow-up. The risk of ischemic cardiovascular events and IMT progression associated with low anti-PC levels was tested by a Cox regression and a logistic regression analysis, respectively. Risk estimates were adjusted by center, gender, age and the conventional cardiovascular risk factors. Results: 3516 were included in the present analysis and 198 incident ischemic cardiovascular events were recorded during a 3 year follow up. Anti-PC levels (U/ml) were classified into quartiles [Q1≤ 40, Q2 >40-≤64, Q3 >64-≤102, Q4 >102] and the highest quartile (Q4) was taken as reference. Presence of low levels (Q1 vs Q4) of anti-PC was associated with an increased risk of CV events in men with a multivariately adjusted HR of 1.76 and 95%CI (1.02-3.03). In men, low levels of anti-PC were found to be associated with the highest (> 90th) percentile of the fastest IMT progression, i.e. the segment showing the fastest progression over 30 months in the whole carotid tree, with an OR of 1.42 (95%CI:1.03-1.98). No significant associations were found in women. Conclusions: These results suggest that low anti-PC serum levels increase the risk of cardiovascular events in men partly through effects on progression of atherosclerosis.
Low levels of IgM antibodies against phosphorylcholine (anti-PC)increase the risk of ischemic cardiovascular events among European men at high risk of cardiovascular events / B. Gigante, K. Leander, R. Strawbridge, B. Sennblad, F. Veglia, D. Baldassarre, E. Tremoli, S. E. Humphries, J. Frostegard, U. De Faire, on behalf of IMPROVE study group. - In: EUROPEAN HEART JOURNAL. - ISSN 0195-668X. - 33:Suppl. 1(2012), pp. 810-810. ((Intervento presentato al convegno Congress of the European Society of Cardiology (ESC) tenutosi a Munchen nel 2012.
Low levels of IgM antibodies against phosphorylcholine (anti-PC)increase the risk of ischemic cardiovascular events among European men at high risk of cardiovascular events
D. Baldassarre;E. Tremoli;
2012
Abstract
Purpose: IgM antibodies against phosphorylcholine (anti-PC) reduce the uptake of oxidized LDL and inhibit the effect of-inflammatory phospholipids, thereby exerting an atheroprotective effect. Prevoius studies have shown that low anti-PC serum levels increase the risk of cardiovascular (CV) events. The aim of the present study was to investigate the association of low levels of anti-PC with the incidence of CV events and the progression of intima media thickness (IMT) in a large cohort of individuals at high risk of cardiovascular diseases contained in the IMPROVE study, a prospective multicenter European study. Methods: 3711 subjects (age 54-79) with at least three established cardiovascular risk factors at enrollment. Serum levels of anti-PC were measured at baseline on all the study participants by ELISA (CV Define, Athera Biotechnologies AB, Stockholm Sweden). Carotid ultrasound investigations were performed at baseline and after 15 and 30 months of follow-up. The risk of ischemic cardiovascular events and IMT progression associated with low anti-PC levels was tested by a Cox regression and a logistic regression analysis, respectively. Risk estimates were adjusted by center, gender, age and the conventional cardiovascular risk factors. Results: 3516 were included in the present analysis and 198 incident ischemic cardiovascular events were recorded during a 3 year follow up. Anti-PC levels (U/ml) were classified into quartiles [Q1≤ 40, Q2 >40-≤64, Q3 >64-≤102, Q4 >102] and the highest quartile (Q4) was taken as reference. Presence of low levels (Q1 vs Q4) of anti-PC was associated with an increased risk of CV events in men with a multivariately adjusted HR of 1.76 and 95%CI (1.02-3.03). In men, low levels of anti-PC were found to be associated with the highest (> 90th) percentile of the fastest IMT progression, i.e. the segment showing the fastest progression over 30 months in the whole carotid tree, with an OR of 1.42 (95%CI:1.03-1.98). No significant associations were found in women. Conclusions: These results suggest that low anti-PC serum levels increase the risk of cardiovascular events in men partly through effects on progression of atherosclerosis.
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