Cross-reactive 1 anti-heart autoantibodies were found in 50% of IRAP patients compared to 4% in non-inflammatory cardiac disease controls (p=0.0001), supporting an autoimmune involvement.
Case-Control (n=611)
No
Are serum anti-heart and anti-intercalated-disk autoantibodies more frequent in patients with idiopathic recurrent acute pericarditis compared to controls?
The presence of anti-heart and anti-intercalated-disk autoantibodies in a majority of patients with idiopathic recurrent acute pericarditis supports an autoimmune etiology for the disease.
Absolute Event Rate: 50% vs 4%
p-value: p=0.0001
BACKGROUND: Idiopathic recurrent acute pericarditis (IRAP) is a rare disease of suspected, yet unproved, immune-mediated origin. The finding of serum heart-specific autoantibodies in IRAP would strengthen the autoimmune hypothesis and provide aetiology-specific non-invasive biomarkers. Objective To assess frequency of serum anti-heart (AHA), anti-intercalated-disk (AIDA) and non-cardiac-specific autoantibodies and their clinical and instrumental correlates in patients with IRAP. Patients 40 consecutive patients with IRAP, 25 male, aged 37+/-16 years, representing a large single-centre cohort collected at a referral centre over a long time period (median 5 years, range 1-22 years). Control groups included patients with non-inflammatory cardiac disease (NICD) (n=160), ischaemic heart failure (n=141) and normal subjects (n=270). METHODS: AHA (organ-specific, cross-reactive 1 and 2 types) and AIDA were detected in serum samples from patients, at last follow-up, and control subjects by indirect immunofluorescence (IIF) on human myocardium and skeletal muscle. Non-cardiac-specific autoantibodies were detected by IIF, and anti-Ro/SSA, anti-La/SSB by ELISA. RESULTS: The frequencies of cross-reactive 1 AHA and of AIDA were higher (50%; 25%) in IRAP than in NICD (4%; 4%), ischaemic (1%; 2%) or normal subjects (3%; 0%) (p=0.0001). AHA and/or AIDA were found in 67.5% patients with IRAP. Of the non-cardiac-specific antibodies, only antinuclear autoantibodies at titre > or =1/160 were more common in IRAP (5%) versus normal (0.5%, p<0.04). AIDA in IRAP were associated with a higher number of recurrences (p=0.01) and hospitalisations (p=0.0001), high titre (1/80 or higher) AHA with a higher number of recurrences (p=0.02). CONCLUSIONS: The detection of AHA and of AIDA supports the involvement of autoimmunity in the majority of patients with IRAP.
Caforio et al. (2010) conducted a case-control in Idiopathic recurrent acute pericarditis (IRAP) (n=611). Serum anti-heart (AHA) and anti-intercalated-disk (AIDA) autoantibodies vs. Non-inflammatory cardiac disease, ischaemic heart failure, and normal subjects was evaluated on Frequency of cross-reactive 1 AHA (p=0.0001). Cross-reactive 1 anti-heart autoantibodies were found in 50% of IRAP patients compared to 4% in non-inflammatory cardiac disease controls (p=0.0001), supporting an autoimmune involvement.