Expression Of Autoantibodies Against ?1-adrenergic Receptor In The Peripheral Blood Of Patients With Acute Coronary Syndrome

Objective: To detect the expression level of autoantibodies against ?1-adrenegic receptors(?1-AA)in peripheral blood of patients with acute coronary syndromes(ACS)and normal subjects,and compare the effects of ?1-AA among ACS patients of different degrees and in order to explore the possible role of ?1-AA in patients with coronary heart disease.Method: 15 healthy cases as control were collected from inpatient treatments of which coronary artery without severe stenosis(stenosis <50% lumen)diagnosed by coronary artery CTA or coronary angiography(CAG),14 patients has only essential hypertension,unstable angina are 40 cases of which 22 cases are hypertensive,35 patients with acute myocardial infarction of which 14 patients are hypertensive were enrolled in this study.The patients with acute myocardial infarction were followed up after the onset of symptoms and at a time pointof 6 hours,12 hours,24 hours,48 hours,72 hours and 1 week and blood sample from anterior cubital vein had been collected in those time point.Blood from patient who are admitted in the ward was collected early morning after overnight fasting and centrifuged at 3g and isolated plasma was harvested from blood samples.The levels of ?1-AA in plasma were measured by enzyme-linked immunosorbent assay(ELISA),and the differences between the groups were compared and analyzed,as well as the ?1-AA level of different time pointsin serum samples of patients with acute myocardial infarction.The relationship between ?1-AA level and GRACE score,syntax score and clinical test index of coronary heart disease were analyzed.One-way ANOVA was used to compare the groups of multiple samples.Pearson correlation analysis was used in bivariate variables which are subject to normal distribution.Risk factors were analyzed by multivariate logistic regression analysis.Results: 1.There is low level expression of the ?1-AA in normal control group.2.There is significant increase in expression level of ?1-AA in serum samples of hypertension patients compared to normal control.3.There is no significant difference in expression level of ?1-AA in serum samples of unstable angina compare to the normal control group.And the serum level of?1-AA is significantly lower in patient with acute myocardial infarction compare to the normal control group(P<0.05).4.There is no significant difference between unstable angina with hypertension and isolated essential hypertensive groups on expression level of ?1-AA.And the expression level of ?1-AA in serum samples of patient with acute myocardial infarction is significantly lower compared to the patients with isolated essential hypertension.(P <0.05).5.The expression level of ?1-AA in serum samples of the patients with unstable angina was significantly higher than that of the acute myocardial infarction group(P <0.05).The level of ?1-AA in serum samples of the patients with unstable angina and hypertension was significantly higher than that of acute myocardial infarction with hypertension group.6.The expression level of the ?1-AA in serum samples of the patients with hypertension and unstable angina is significantly higher compared to the patients with only unstable angina(P <0.05),but there was no significant difference of expression level of ?1-AA between patients with both hypertension and acute myocardial infarction and those with only acute myocardial infarction.(P>0.05).7.There was no significant difference in serum level of ?1-AA between 12 h,72h and 1week time points after the onset of acute myocardial infarction(P >0.05),but declined compared to 6h.8.The Pearson correlation analysis of GRACE score and ?1-AAin ACS patients showed a negative linear relationship(R =-0.516,P<0.01).9.The regression coefficient of ?1-AA in patients with acute myocardial infarction is0.038,P<0.01,95.0% Confidence Interval(CI)is 1.017?1.061;The regression coefficient of white blood cell(WBC)is ?0.587,P<0.01,95.0%CI is 0.392?0.788.Conclusion: The expression of ?1-AA in serum of patients with acute myocardial infarction was decreased,and was negatively correlated with the severity of the disease.