Background: Systemic sclerosis (SSc) is a polysystemic autoimmune disorder characterized by exces... more Background: Systemic sclerosis (SSc) is a polysystemic autoimmune disorder characterized by excessive production of extracellular matrix and vascular abnormalities, involving the skin and internal organs. There is currently no real disease-modifying therapy of SSc and there are only few reports on the use of plasmapheresis in SSc. Objectives: Authors present 4 cases of SSc treated with plasmapheresis within one year from disease onset. All patients had diffuse cutaneous form of SSc with rapid progression and with different internal organ manifestations. Methods: The patients were treated with plasmapheresis performed every 3 months besides symptomatic drug treatment. Clinical symptoms, Rodnan skin score, immunolaboratory markers (serum immunoglobulin, complement, several autoantibodies, leukocyte CD markers) and soluble adhesion molecules (E-selectin, intercellular adhesion molecule 1, vascular cell adhesion molecule, which were showed as the markers of disease activity in previous works) were determined before and after the plasmapheresis. Results: The progression of the disease slowed down significantly in all patients, no more new clinical manifestation appeared, Rodnan skin score significantly decreased. There was a reduction in CD4/CD8 ratio (approaching normal ratio), in expression of CD69, as early activation marker. There was a significant suppression of soluble adhesion molecules also in all patients. Conclusion: In patients with diffuse cutaneous form of SSc, plasmapheresis may be effective with decreasing progression of the disease and improving clinical symptoms (especially skin manifestation) in the early phase of the disease.
Background: Increased cardiovascular morbidity has become a leading cause of mortality in rheumat... more Background: Increased cardiovascular morbidity has become a leading cause of mortality in rheumatoid arthritis (RA). Tumor necrosis factor-alpha (TNFa) inhibitors may influence flow-mediated vasodilation (FMD) of the brachial artery, common carotid intima-media thickness (ccIMT) and arterial stiffness indicated by pulse-wave velocity (PWV) in RA. Objectives: To assess the effects of adalimumab treatment on FMD, ccIMT and PWV in early RA. Methods: Eight RA patients with a disease duration < or =1 year received 40 mg adalimumab subcutaneously every 2 weeks. Ultrasound was used to assess brachial FMD and ccIMT. PWV was determined by arteriograph. These parameters were correlated with C-reactive protein, vonWillebrand factor (vWF), immunoglobulin M (IgM)-rheumatoid factor (RF), anti-CCP levels and 28-joint disease activity score (DAS28). Results: Adalimumab therapy successfully ameliorated arthritis as it decreased CRP levels (P = 0.04) and DAS28 (P < 0.0001). Endothelial function (FMD) improved in comparison to baseline (P < 0.05). ccIMT decreased after 24 weeks, indicating a mean 11.9% significant improvement (P = 0.002). Adalimumab relieved arterial stiffness (PWV) after 24 weeks. Although plasma vWF levels decreased only non-significantly after 12 weeks of treatment, an inverse correlation was found between FMD and vWF (R = -0.643, P = 0.007). FMD also inversely correlated with CRP (R = -0.596, P= 0.015). CRP and vWF also correlated with each other (R = 0.598, P = 0.014). PWV and ccIMT showed a positive correlation (R = 0.735, P = 0.038). Conclusions: Treatment with adalimumab exerted favorable effects on disease activity and endothelial dysfunction. It also ameliorated carotid atherosclerosis and arterial stiffness in patients with early RA. Early adalimumab therapy may have an important role in the prevention and management of vascular comorbidity in RA.
Annals of the New York Academy of Sciences, Jun 1, 2007
: Cardiovascular disease is a leading cause of mortality in rheumatoid arthritis (RA). Endotheli... more : Cardiovascular disease is a leading cause of mortality in rheumatoid arthritis (RA). Endothelial dysfunction often precedes manifest atherosclerosis. Both traditional, Framingham risk factors and inflammation‐associated factors are involved in RA‐associated atherosclerosis. Among imaging techniques, the early determination of common carotid intima‐media thickness (ccIMT), flow‐mediated vasodilation (FMD), and nitroglycerine‐mediated vasodilation (NMD) may be useful to determine atherosclerosis and endothelial dysfunction. We and others found increased ccIMT and impaired FMD in RA patients. Among immunological and metabolic laboratory markers, anticyclic citrullinated peptide (anti‐CCP) antibodies, IgM rheumatoid factor, circulating immune complexes, pro‐inflammatory cytokines including tumor necrosis factor‐α (TNF‐α) and interleukin‐6 (IL‐6), Th0/Th1 T cells, homocysteine, dyslipidemia, decreased folate and vitamin B12 production, and impaired paraoxonase activity may all be involved in the development of vascular disease in RA. The early diagnosis of endothelial dysfunction and atherosclerosis, active immunosuppressive treatment, the use of drugs that control atherosclerosis, changes in sedentary lifestyle, and the close follow‐up of RA patients may help to minimize cardiovascular risk in these individuals.
Background: Impaired lipid metabolism contributes to accelerated inflammatory responses in additi... more Background: Impaired lipid metabolism contributes to accelerated inflammatory responses in addition to promoting the formation of atherosclerosis in systemic lupus erythematosus (SLE). We aimed to evaluate the lipid profile, inflammatory markers, and vascular diagnostic tests in active SLE patients to clarify the association between dyslipidemia and early vascular damage. Patients and Methods: 51 clinically active SLE patients and 41 age- and gender-matched control subjects were enrolled in the study. Lipoprotein subfractions were detected by Lipoprint. Brachial artery flow-mediated dilation and common carotid intima-media thickness were detected by ultrasonography. Arterial stiffness indicated by augmentation index (Aix) and pulse wave velocity was measured by arteriography. Results: We found significantly higher Aix, higher VLDL ratio, plasma triglyceride, ApoB100, and small HDL, as well as lower HDL-C, large HDL, and ApoA1 in patients with SLE. There was a significant positive co...
Az utóbbi időben vált nyilvánvalóvá, hogy a gyulladásos reumatológiai kórképek, így a rheumatoid ... more Az utóbbi időben vált nyilvánvalóvá, hogy a gyulladásos reumatológiai kórképek, így a rheumatoid arthritis (RA) is, felgyorsult (akcelerált) atherosclerosissal jár. Ennek következtében megnő a cardiovascularis és cerebrovascularis morbiditás és mortalitás, ami a RA-es betegek megnövekedett halálozásának 30-50%-áért tehető felelőssé [1–5]. A RA hasonló fokú rizikófaktornak tekinthető, mint a II. típusú diabetes [6]. Természetesen RA-ben is fontos a hagyományos cardiovascularis rizikófaktorok, így a dohányzás, elhízás, diszlipidémia szerepe, de számos vizsgálat utal arra, hogy a szisztémás gyulladás, a tartós betegségaktivitás és a magas CRP-szint tekinthető a legfontosabb tényezőknek [5, 7–9]. Az atherosclerotikus plakk sok tekintetben hasonló a gyulladt RA synoviumhoz. Mindkettő macrophagokat és T-sejteket, pro-inflammatorikus cytokineket, így tumor nekrózis factor α-t (TNF-α), chemokineket, hősokk-fehérjéket (hsp), proteázokat tartalmaz [9–12]. Egyértelművé vált tehát, hogy az alap...
Increased cardiovascular (CV) morbidity and mortality have been found in rheumatoid arthritis (RA... more Increased cardiovascular (CV) morbidity and mortality have been found in rheumatoid arthritis (RA). Tumour necrosis factor α (TNF-α) inhibitors may improve vascular function. In the first part of this study, we determined microcirculation during postoocclusive reactive hyperemia (PORH) representing endothelial function. In a nonselected population (n = 46) we measured flow-mediated vasodilation (FMD) of the brachial artery and laser Doppler flow (LDF) by ultrasound. Among LDF parameters, we determined TH1 (time to half before hyperemia), TH2 (time to half after hyperemia), Tmax (time to maximum) and total hyperemic area (AH). We measured von Willebrand antigen (vWF:Ag) by ELISA. In the second part of the study, we assessed the effects of adalimumab treatment on microcirculatory parameters in 8 early RA patients at 0, 2, 4, 8 and 12 weeks. We found significant positive correlations between FMD and LDF Tmax (R = 0.456, p = 0.002), FMD and TH2 (R = 0.435, p = 0.004), and negative corre...
Aim: Microangiopathy and neuropathy are late and severe complications of diabetes mellitus. Our a... more Aim: Microangiopathy and neuropathy are late and severe complications of diabetes mellitus. Our aim was to examine the connection between neuropathy and microcirculatory disorder in type 2 diebetic patients in the mirror of metabolic state. Methods: In our study 50 patients with type 2 DM and symptoms of neuropathy were enrolled. The microcirculatary impairment was examined by Laser-Doppler flowmetry. Provocation probe, the venoarterial refex (VA) was implicated. The venoarterial reflex is is the decline in limb blood flow in the dependent position due to an increase in pre-capillary vascular resistance. To reify neuropathy, electroneurography (ENG) has been performed. Laboratory tests included lipid parameters and Hg A1C level. Examinations were done in age and sex matched control group. Results: During VA, decline in blood flow was sifgnificantly higher in the control group (78% vs. 31,8%; p<0,001). The results proved micrirculatory impairment. ENG confirmed peripherial neuropathy in every patient. Significant correlation could be detected between VA and triglyceride (R=0,35, p=0,015) and Hg A1C (R=0,322, p=0,024). There was no significant correlation between the VA and avarage disease course or severity of neuropathy. Conclusions: Our results show that VA is an excellent method to detect both neuropathy and microangiopathy in DM. Because of the relationship between the VA and glycemic control, the VA could be suitable for monitoring the effects of new therapies in DM.
To study the occurrence of valvulopathies after treatment in Hodgkin's disease patients. 124 ... more To study the occurrence of valvulopathies after treatment in Hodgkin's disease patients. 124 Hodgkin's disease patients in complete remission for at least 1 year were echocardiographically examined. Abnormal finding was observed in 48/124 (38.4%) of patients, all of them presented with regurgitation, no stenosis was observed. Regurgitation of grade I or II was recorded in most cases. We have found single valvulopathy in 25/48 (52.1%) of patients, and multiple valvulopathy in 23/48 (47.9%) of patients. In most cases (78.7%) the valvulopathy was detected in left heart. Among these 48 patients the ratio of females was significantly higher than those of males, and also the ratio of the patients in early phase compared with those in late phase. We could detect vitium mostly in those patients who had mediastinal irradiation. The combined treatment, including anthracycline therapy, did not increase the frequency of vitium. The occurrence of valvulopathy is frequent in Hodgkin's...
To investigate the relationship between antiprothrombin (aPT) and antiannexin V (aANX) autoantibo... more To investigate the relationship between antiprothrombin (aPT) and antiannexin V (aANX) autoantibodies of IgG isotype and thrombosis in patients with systemic autoimmune diseases. To compare the clinical relevance of these antibodies to that of anticardiolipin (aCL), anti-beta2-glycoprotein I antibodies (anti-beta2-GPI), and lupus anticoagulant (LAC). Serum IgG aPT, aANX, aCL, and anti-beta2-GPI levels were measured by solid phase enzyme immunoassay in the sera of 70 patients with systemic autoimmune diseases, 35 with antiphospholipid syndrome (APS) and 35 without APS. Medical records were analyzed, and associations of the antibodies with clinical features of APS were assessed. Patients with APS had higher frequency of aPT (p = 0.001) and aANX (p = 0.002) compared to patients without APS. Thrombotic events occurred more frequently in those with aPT or aANX than those without (p = 0.005, p = 0.006, respectively). The presence of aPT and aANX was found to be highly specific for APS. Me...
Objectives. Circulating IgG antibodies to oxidized low-density lipoprotein (anti-oxLDL) have been... more Objectives. Circulating IgG antibodies to oxidized low-density lipoprotein (anti-oxLDL) have been implicated in the development of atherosclerotic plaques. In this study, we investigated the prognostic value of IgG anti-oxLDL antibodies in patients with acute coronary syndrome (ACS). Methods. In total 54 patients with ACS and 41 matched healthy controls were involved in this prospective study. Serum IgG anti-oxLDL levels were assessed by ELISA. Results. Higher IgG anti-oxLDL levels were found in patients with ACS versus controls (22.8 ± 23.3 vs. 7.5 ± 5.27 EU/ml, p < 0.0001). IgG anti-oxLDL concentrations were significantly higher in ACS patients with unstable clinical complications (circulatory insufficiency, malignant arrhythmias, recurring ischaemic pain, positive stress-test, need for urgent coronary intervention or sudden cardiac death) versus those without such complications (30.0 vs. 11.7 EU/ml, p < 0.001). Twelve patients (22%) were taking statins. Patients on statins ...
We retrospectively analysed the data of 1519 antiphospholipid antibody (APLA) positive patients b... more We retrospectively analysed the data of 1519 antiphospholipid antibody (APLA) positive patients between 1986 and 1999. Among them 637 were considered to have antiphospholipid syndrome (APS) based on the 1999 preliminary classification criteria, while 704 patients had no clinical signs of the syndrome. Our aim was to compare the autoantibody profile and clinical characteristics of primary and secondary APS, moreover to evaluate the associations between different APLA and specific symptoms attributable to APS. In our results, the APLA profiles for primary and SLE-associated secondary APS were similar. Among the evaluated clinical symptoms, cerebrovascular thrombosis was found to be more frequent in the SLE-associated, than in the primary APS group (P = 0.04). We identified important differences in the clinical profile of patient populations with various types of APLA. Venous thrombosis occurred more frequently in subjects with lupus anticoagulant (LA), than in those with IgG or IgM ty...
Background: Systemic sclerosis (SSc) is a polysystemic autoimmune disorder characterized by exces... more Background: Systemic sclerosis (SSc) is a polysystemic autoimmune disorder characterized by excessive production of extracellular matrix and vascular abnormalities, involving the skin and internal organs. There is currently no real disease-modifying therapy of SSc and there are only few reports on the use of plasmapheresis in SSc. Objectives: Authors present 4 cases of SSc treated with plasmapheresis within one year from disease onset. All patients had diffuse cutaneous form of SSc with rapid progression and with different internal organ manifestations. Methods: The patients were treated with plasmapheresis performed every 3 months besides symptomatic drug treatment. Clinical symptoms, Rodnan skin score, immunolaboratory markers (serum immunoglobulin, complement, several autoantibodies, leukocyte CD markers) and soluble adhesion molecules (E-selectin, intercellular adhesion molecule 1, vascular cell adhesion molecule, which were showed as the markers of disease activity in previous works) were determined before and after the plasmapheresis. Results: The progression of the disease slowed down significantly in all patients, no more new clinical manifestation appeared, Rodnan skin score significantly decreased. There was a reduction in CD4/CD8 ratio (approaching normal ratio), in expression of CD69, as early activation marker. There was a significant suppression of soluble adhesion molecules also in all patients. Conclusion: In patients with diffuse cutaneous form of SSc, plasmapheresis may be effective with decreasing progression of the disease and improving clinical symptoms (especially skin manifestation) in the early phase of the disease.
Background: Increased cardiovascular morbidity has become a leading cause of mortality in rheumat... more Background: Increased cardiovascular morbidity has become a leading cause of mortality in rheumatoid arthritis (RA). Tumor necrosis factor-alpha (TNFa) inhibitors may influence flow-mediated vasodilation (FMD) of the brachial artery, common carotid intima-media thickness (ccIMT) and arterial stiffness indicated by pulse-wave velocity (PWV) in RA. Objectives: To assess the effects of adalimumab treatment on FMD, ccIMT and PWV in early RA. Methods: Eight RA patients with a disease duration < or =1 year received 40 mg adalimumab subcutaneously every 2 weeks. Ultrasound was used to assess brachial FMD and ccIMT. PWV was determined by arteriograph. These parameters were correlated with C-reactive protein, vonWillebrand factor (vWF), immunoglobulin M (IgM)-rheumatoid factor (RF), anti-CCP levels and 28-joint disease activity score (DAS28). Results: Adalimumab therapy successfully ameliorated arthritis as it decreased CRP levels (P = 0.04) and DAS28 (P < 0.0001). Endothelial function (FMD) improved in comparison to baseline (P < 0.05). ccIMT decreased after 24 weeks, indicating a mean 11.9% significant improvement (P = 0.002). Adalimumab relieved arterial stiffness (PWV) after 24 weeks. Although plasma vWF levels decreased only non-significantly after 12 weeks of treatment, an inverse correlation was found between FMD and vWF (R = -0.643, P = 0.007). FMD also inversely correlated with CRP (R = -0.596, P= 0.015). CRP and vWF also correlated with each other (R = 0.598, P = 0.014). PWV and ccIMT showed a positive correlation (R = 0.735, P = 0.038). Conclusions: Treatment with adalimumab exerted favorable effects on disease activity and endothelial dysfunction. It also ameliorated carotid atherosclerosis and arterial stiffness in patients with early RA. Early adalimumab therapy may have an important role in the prevention and management of vascular comorbidity in RA.
Annals of the New York Academy of Sciences, Jun 1, 2007
: Cardiovascular disease is a leading cause of mortality in rheumatoid arthritis (RA). Endotheli... more : Cardiovascular disease is a leading cause of mortality in rheumatoid arthritis (RA). Endothelial dysfunction often precedes manifest atherosclerosis. Both traditional, Framingham risk factors and inflammation‐associated factors are involved in RA‐associated atherosclerosis. Among imaging techniques, the early determination of common carotid intima‐media thickness (ccIMT), flow‐mediated vasodilation (FMD), and nitroglycerine‐mediated vasodilation (NMD) may be useful to determine atherosclerosis and endothelial dysfunction. We and others found increased ccIMT and impaired FMD in RA patients. Among immunological and metabolic laboratory markers, anticyclic citrullinated peptide (anti‐CCP) antibodies, IgM rheumatoid factor, circulating immune complexes, pro‐inflammatory cytokines including tumor necrosis factor‐α (TNF‐α) and interleukin‐6 (IL‐6), Th0/Th1 T cells, homocysteine, dyslipidemia, decreased folate and vitamin B12 production, and impaired paraoxonase activity may all be involved in the development of vascular disease in RA. The early diagnosis of endothelial dysfunction and atherosclerosis, active immunosuppressive treatment, the use of drugs that control atherosclerosis, changes in sedentary lifestyle, and the close follow‐up of RA patients may help to minimize cardiovascular risk in these individuals.
Background: Impaired lipid metabolism contributes to accelerated inflammatory responses in additi... more Background: Impaired lipid metabolism contributes to accelerated inflammatory responses in addition to promoting the formation of atherosclerosis in systemic lupus erythematosus (SLE). We aimed to evaluate the lipid profile, inflammatory markers, and vascular diagnostic tests in active SLE patients to clarify the association between dyslipidemia and early vascular damage. Patients and Methods: 51 clinically active SLE patients and 41 age- and gender-matched control subjects were enrolled in the study. Lipoprotein subfractions were detected by Lipoprint. Brachial artery flow-mediated dilation and common carotid intima-media thickness were detected by ultrasonography. Arterial stiffness indicated by augmentation index (Aix) and pulse wave velocity was measured by arteriography. Results: We found significantly higher Aix, higher VLDL ratio, plasma triglyceride, ApoB100, and small HDL, as well as lower HDL-C, large HDL, and ApoA1 in patients with SLE. There was a significant positive co...
Az utóbbi időben vált nyilvánvalóvá, hogy a gyulladásos reumatológiai kórképek, így a rheumatoid ... more Az utóbbi időben vált nyilvánvalóvá, hogy a gyulladásos reumatológiai kórképek, így a rheumatoid arthritis (RA) is, felgyorsult (akcelerált) atherosclerosissal jár. Ennek következtében megnő a cardiovascularis és cerebrovascularis morbiditás és mortalitás, ami a RA-es betegek megnövekedett halálozásának 30-50%-áért tehető felelőssé [1–5]. A RA hasonló fokú rizikófaktornak tekinthető, mint a II. típusú diabetes [6]. Természetesen RA-ben is fontos a hagyományos cardiovascularis rizikófaktorok, így a dohányzás, elhízás, diszlipidémia szerepe, de számos vizsgálat utal arra, hogy a szisztémás gyulladás, a tartós betegségaktivitás és a magas CRP-szint tekinthető a legfontosabb tényezőknek [5, 7–9]. Az atherosclerotikus plakk sok tekintetben hasonló a gyulladt RA synoviumhoz. Mindkettő macrophagokat és T-sejteket, pro-inflammatorikus cytokineket, így tumor nekrózis factor α-t (TNF-α), chemokineket, hősokk-fehérjéket (hsp), proteázokat tartalmaz [9–12]. Egyértelművé vált tehát, hogy az alap...
Increased cardiovascular (CV) morbidity and mortality have been found in rheumatoid arthritis (RA... more Increased cardiovascular (CV) morbidity and mortality have been found in rheumatoid arthritis (RA). Tumour necrosis factor α (TNF-α) inhibitors may improve vascular function. In the first part of this study, we determined microcirculation during postoocclusive reactive hyperemia (PORH) representing endothelial function. In a nonselected population (n = 46) we measured flow-mediated vasodilation (FMD) of the brachial artery and laser Doppler flow (LDF) by ultrasound. Among LDF parameters, we determined TH1 (time to half before hyperemia), TH2 (time to half after hyperemia), Tmax (time to maximum) and total hyperemic area (AH). We measured von Willebrand antigen (vWF:Ag) by ELISA. In the second part of the study, we assessed the effects of adalimumab treatment on microcirculatory parameters in 8 early RA patients at 0, 2, 4, 8 and 12 weeks. We found significant positive correlations between FMD and LDF Tmax (R = 0.456, p = 0.002), FMD and TH2 (R = 0.435, p = 0.004), and negative corre...
Aim: Microangiopathy and neuropathy are late and severe complications of diabetes mellitus. Our a... more Aim: Microangiopathy and neuropathy are late and severe complications of diabetes mellitus. Our aim was to examine the connection between neuropathy and microcirculatory disorder in type 2 diebetic patients in the mirror of metabolic state. Methods: In our study 50 patients with type 2 DM and symptoms of neuropathy were enrolled. The microcirculatary impairment was examined by Laser-Doppler flowmetry. Provocation probe, the venoarterial refex (VA) was implicated. The venoarterial reflex is is the decline in limb blood flow in the dependent position due to an increase in pre-capillary vascular resistance. To reify neuropathy, electroneurography (ENG) has been performed. Laboratory tests included lipid parameters and Hg A1C level. Examinations were done in age and sex matched control group. Results: During VA, decline in blood flow was sifgnificantly higher in the control group (78% vs. 31,8%; p<0,001). The results proved micrirculatory impairment. ENG confirmed peripherial neuropathy in every patient. Significant correlation could be detected between VA and triglyceride (R=0,35, p=0,015) and Hg A1C (R=0,322, p=0,024). There was no significant correlation between the VA and avarage disease course or severity of neuropathy. Conclusions: Our results show that VA is an excellent method to detect both neuropathy and microangiopathy in DM. Because of the relationship between the VA and glycemic control, the VA could be suitable for monitoring the effects of new therapies in DM.
To study the occurrence of valvulopathies after treatment in Hodgkin's disease patients. 124 ... more To study the occurrence of valvulopathies after treatment in Hodgkin's disease patients. 124 Hodgkin's disease patients in complete remission for at least 1 year were echocardiographically examined. Abnormal finding was observed in 48/124 (38.4%) of patients, all of them presented with regurgitation, no stenosis was observed. Regurgitation of grade I or II was recorded in most cases. We have found single valvulopathy in 25/48 (52.1%) of patients, and multiple valvulopathy in 23/48 (47.9%) of patients. In most cases (78.7%) the valvulopathy was detected in left heart. Among these 48 patients the ratio of females was significantly higher than those of males, and also the ratio of the patients in early phase compared with those in late phase. We could detect vitium mostly in those patients who had mediastinal irradiation. The combined treatment, including anthracycline therapy, did not increase the frequency of vitium. The occurrence of valvulopathy is frequent in Hodgkin's...
To investigate the relationship between antiprothrombin (aPT) and antiannexin V (aANX) autoantibo... more To investigate the relationship between antiprothrombin (aPT) and antiannexin V (aANX) autoantibodies of IgG isotype and thrombosis in patients with systemic autoimmune diseases. To compare the clinical relevance of these antibodies to that of anticardiolipin (aCL), anti-beta2-glycoprotein I antibodies (anti-beta2-GPI), and lupus anticoagulant (LAC). Serum IgG aPT, aANX, aCL, and anti-beta2-GPI levels were measured by solid phase enzyme immunoassay in the sera of 70 patients with systemic autoimmune diseases, 35 with antiphospholipid syndrome (APS) and 35 without APS. Medical records were analyzed, and associations of the antibodies with clinical features of APS were assessed. Patients with APS had higher frequency of aPT (p = 0.001) and aANX (p = 0.002) compared to patients without APS. Thrombotic events occurred more frequently in those with aPT or aANX than those without (p = 0.005, p = 0.006, respectively). The presence of aPT and aANX was found to be highly specific for APS. Me...
Objectives. Circulating IgG antibodies to oxidized low-density lipoprotein (anti-oxLDL) have been... more Objectives. Circulating IgG antibodies to oxidized low-density lipoprotein (anti-oxLDL) have been implicated in the development of atherosclerotic plaques. In this study, we investigated the prognostic value of IgG anti-oxLDL antibodies in patients with acute coronary syndrome (ACS). Methods. In total 54 patients with ACS and 41 matched healthy controls were involved in this prospective study. Serum IgG anti-oxLDL levels were assessed by ELISA. Results. Higher IgG anti-oxLDL levels were found in patients with ACS versus controls (22.8 ± 23.3 vs. 7.5 ± 5.27 EU/ml, p < 0.0001). IgG anti-oxLDL concentrations were significantly higher in ACS patients with unstable clinical complications (circulatory insufficiency, malignant arrhythmias, recurring ischaemic pain, positive stress-test, need for urgent coronary intervention or sudden cardiac death) versus those without such complications (30.0 vs. 11.7 EU/ml, p < 0.001). Twelve patients (22%) were taking statins. Patients on statins ...
We retrospectively analysed the data of 1519 antiphospholipid antibody (APLA) positive patients b... more We retrospectively analysed the data of 1519 antiphospholipid antibody (APLA) positive patients between 1986 and 1999. Among them 637 were considered to have antiphospholipid syndrome (APS) based on the 1999 preliminary classification criteria, while 704 patients had no clinical signs of the syndrome. Our aim was to compare the autoantibody profile and clinical characteristics of primary and secondary APS, moreover to evaluate the associations between different APLA and specific symptoms attributable to APS. In our results, the APLA profiles for primary and SLE-associated secondary APS were similar. Among the evaluated clinical symptoms, cerebrovascular thrombosis was found to be more frequent in the SLE-associated, than in the primary APS group (P = 0.04). We identified important differences in the clinical profile of patient populations with various types of APLA. Venous thrombosis occurred more frequently in subjects with lupus anticoagulant (LA), than in those with IgG or IgM ty...
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