Key result
Antinuclear antibody positivity was significantly more prevalent in patients with acute aortic syndrome compared to controls (39.0% vs 15.8%, p=0.001).
Why the study?
The possible influence of antinuclear antibodies in acute aortic syndromes had not been elucidated.
Is anti-nuclear antibody (ANA) positivity associated with the occurrence of acute aortic syndrome in patients presenting with chest pain?
Case-Control (n=153)
No
Is anti-nuclear antibody (ANA) positivity associated with the occurrence of acute aortic syndrome in patients presenting with chest pain?
Effect estimate: r = 0.224
Absolute Event Rate: 39% vs 15.8%
p-value: p=0.001
Anti-nuclear antibody positivity is significantly associated with the incidence of acute aortic syndromes, suggesting a potential autoimmune or inflammatory component in its pathogenesis.
ANA positivity may flag higher-risk chest pain patients; leaves open an autoimmune role in acute aortic syndrome pathogenesis.
Markers of serological autoimmunity such as anti-nuclear antibodies (ANA) are noted in approximately 14.01% of the Chinese population. The vast majority will do not have clinical autoimmune disease. However, the possible influence of antinuclear antibodies in acute aortic syndromes (AAS) has not been elucidated. The study group included 77 patients who underwent AAS. Serum levels of antinuclear (ANA) were tested. Patients detailed data on AAS risk factors and markers of subclinical index (including C-reactive protein, D-dimmer, Glucose, Creatine kinase) were available. Results: Of the 77 patients with AAS, 40 had classic acute aortic dissection 29 variants intramural hematoma (IMH) and 8 penetrating atherosclerotic ulcer (PAU). Among the control group, 12/76 (15.8%) were ANA positive. In marked contrast, among the study subjects 30/77 (39.0%) were ANA positive. There is a higher incidence of ANA positivity among the study group than among the control group (p = 0.001). The presence of ANAs was related to the occurrence of AAS (r = 0.224, p = 0.005). Meanwhile, the positive ANAs were correlated with atherosclerosis (r = 0.167, p = 0.039), the red blood cell count (r = −0.245, p = 0.002) and C-reactive protein (r = 0.181, p = 0.042). Our results indicate that ANA positivity is associated with incidence of AAS, especially the incidence of intramural hematoma (IMH), suggesting that mechanisms resulting in ANA production may be involved in the development of AAS.
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Shi et al. (2020) conducted a case-control in Acute aortic syndrome (n=153). Antinuclear antibodies (ANA) positivity vs. Control group without acute aortic syndrome was evaluated on Incidence of ANA positivity (r = 0.224, p=0.001). Antinuclear antibody positivity was significantly more prevalent in patients with acute aortic syndrome compared to controls (39.0% vs 15.8%, p=0.001).
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