ABSTRACT
Peripheral artery disease (PAD) is mostly related to atherosclerosis. Autoimmunity and, in particular, antibodies to cardiolipin (aCL) and phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) might influence the development of atheroma. Beta2-glycoprotein I (beta2-gpI) has been found in atheroma. It has previously been shown that immunoglobulin A (IgA) anti-beta2-gpI antibodies are associated with a risk of cerebral ischemia and myocardial infarction. This case control study aimed to determine whether elevated levels of aCL/anti-beta2-gpI antibodies are associated with a risk of symptomatic PAD (sPAD). Cases comprised a nonselected population of patients with sPAD (intermittent claudication or critical ischemia). Patient recruitment was based on arteriography changes. Controls were selected from patients admitted to orthopedic wards as a result of fractures or muscle-ligamentous disorders. Age, sex, race, hypertension, smoking, diabetes mellitus, and hypercholesterolemia were evaluated as risk factors in both groups. IgG/IgM/IgA aCL and anti-beta2-gpI were detected by enzyme-linked immunoabsorbant assays (ELISA). To estimate the grade of association of antibodies with sPAD, odds ratios (OR) were calculated. Logistic regression was utilized for adjustment of confounding factors. Seventy-seven cases and 93 controls were studied. The mean age was 61.5 years for cases and 47.5 years for controls (p <0.001). Among the risk factors evaluated, the presence of hypertension showed the strongest association with sPAD (OR 12.1; 95%CI 5.8-30). The presence of IgA anti-beta2-gpI was independently associated with sPAD (OR 5.4; 95%CI 1.8-15.8; p = 0.01). IgA aCL was strongly associated with the outcome (nonadjusted OR 11.5 after Agresti correction). IgA aCL and IgA anti-beta2-gpI antibodies were not associated with any known risk factors for sPAD or with arteriography changes. The occurrence of these autoantibodies might represent one of the links between autoimmunity and atherosclerosis in patients with sPAD.
Subject(s)
Atherosclerosis/immunology , Autoantibodies/blood , Autoimmunity , Peripheral Vascular Diseases/immunology , beta 2-Glycoprotein I/immunology , Adult , Aged , Antibodies, Anticardiolipin/blood , Atherosclerosis/epidemiology , Case-Control Studies , Diabetes Complications/immunology , Female , Humans , Hypercholesterolemia/complications , Hypertension/complications , Incidence , Logistic Models , Male , Middle Aged , Odds Ratio , Peripheral Vascular Diseases/epidemiology , Risk Assessment , Risk Factors , Smoking/adverse effectsSubject(s)
Adenocarcinoma/blood , Antibodies, Antiphospholipid/blood , Lung Neoplasms/blood , Prostatic Neoplasms/blood , Venous Thrombosis/blood , Adenocarcinoma/immunology , Aged , Humans , Lung Neoplasms/immunology , Lung Neoplasms/secondary , Male , Middle Aged , Prostatic Neoplasms/immunology , Venous Thrombosis/immunologySubject(s)
Humans , Male , Middle Aged , Adenocarcinoma/blood , Antibodies, Antiphospholipid/blood , Lung Neoplasms/blood , Prostatic Neoplasms/blood , Venous Thrombosis/blood , Adenocarcinoma/immunology , Lung Neoplasms/immunology , Lung Neoplasms/secondary , Prostatic Neoplasms/immunology , Venous Thrombosis/immunologyABSTRACT
A síndrome antifosfolipídica (SAF) é a mais comum das trombofilias adquiridas do adulto jovem. Ocorre de forma primária ou em associação com doenças do conjuntivo, particularmente o lupus eritematoso. A ocorrência de eventos obstrétricos em pacientes com SAF é assunto de grande interesse entre profissionais da área da Reumatologia e Gineco-Obstetricia. Abordamos, neste artigo, aspectos conceituais da SAF e os eventos obstétricos (abortamentos recorrentes, pré-eclâmpsia) relacionados à presença dos anticorpos contra fosfolípides.
Subject(s)
Humans , Male , Female , Pregnancy , Adult , Abortion, Habitual , Antibodies, Antiphospholipid , Pre-Eclampsia , Antiphospholipid SyndromeABSTRACT
OBJECTIVE: To assess the relation between coronary artery disease and the calcification index on helical computed tomography. METHOD: We studied 22 patients (ages ranging from 40 to 70 years) who underwent coronary angiography because of chest pain suggestive of angina pectoris. Findings on coronary angiography were classified as follows: significant obstructive disease (stenosis > or = 50 percent), nonobstructive disease (stenosis <50 percent), and no disease. With no previous knowledge of the results of the coronary angiography and within 7 days, helical computed tomography of the chest was performed. Then, data of the coronary angiography were correlated with the calcification index obtained by helical computed tomography. RESULTS: The sensitivity of helical computed tomography to the presence of significant obstructive lesions on coronary angiography was 87.5 percent, specificity was 100 percent, and negative and positive predictive values were 75 percent and 100 percent, respectively. The mean calcification index was greater in patients with severe coronary lesions, mainly when involvement of 2 or 3 vessels occurred, than that in patients with no coronary artery disease or with nonobstructive coronary artery lesions (p<0.05). CONCLUSION: Helical computed tomography is an effective method for detecting and quantifying coronary artery calcification, and it has proved to be sensitive to and specific for the noninvasive diagnosis of coronary artery stenosis
Subject(s)
Humans , Adult , Middle Aged , Male , Female , Calcinosis , Coronary Angiography/methods , Coronary Disease , Tomography, X-Ray Computed , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
Trabalho de revisäo bilbiográfica sobre a Síndrome de West, apontando aspectos relevantes quanto a sua conceituaçäo, epidemiologia, classificaçäo, etiopatogenia, quadro clínico, diagnóstico diferencial, tratamento e prognóstico...
