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Impact of troponin I-autoantibodies in chronic dilated and ischemic cardiomyopathy

Impact of troponin I-autoantibodies in chronic dilated and ischemic cardiomyopathy,10.1007/s00395-010-0126-z,Basic Research in Cardiology,Andreas O. D

Impact of troponin I-autoantibodies in chronic dilated and ischemic cardiomyopathy   (Citations: 1)
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The aim of this study was to investigate the prognostic value of circulating troponin I (TNI)-autoantibodies in plasma of patients with chronic heart failure. Sera of 390 heart failure patients were tested for the presence of anti-TNI antibodies by enzyme-linked immunosorbent assay (ELISA), including 249 (63.8% of total) patients with dilated cardiomyopathy (DCM) and 141 (36.2% of total) patients with ischemic cardiomyopathy (ICM). A total of 72 patients (18.5% of total) were female and 318 (81.5% of total) were male. Mean patient age was 54.6 ± 11.3 years and mean follow-up time was 3.8 ± 3.2 years. TNI-autoantibodies (titer of ≥1:40) were detected in 73 out of 390 patients (18.7% of total). In TNI-autoantibody positive patients mean left ventricular ejection fraction (LVEF) was 27.6 ± 5.8%, compared to 25.8 ± 5.9% in TNI-autoantibody negative patients, P = 0.03. The combined end-point of death (n = 118, 30.3% of total) or heart transplantation (HTX) (n = 44, 11.3% of total) was reached in 162 patients (41.5% of total). Kaplan–Meier analysis demonstrated superior survival (combined end-point of death or HTX) in patients with DCM versus ICM (P = 0.0198) and TNI-autoantibody positive patients versus TNI-autoantibody negative patients (P = 0.0348). Further subgroup analysis revealed a favorable outcome in TNI-positive patients with heart failure if the patients suffered from DCM (P = 0.0334), whereas TNI-autoantibody status in patients with ICM was not associated with survival (P = 0.8486). In subsequent multivariate Weibull-analysis, a positive TNI serostatus was associated with a significantly lower all-cause mortality in DCM patients (P = 0.0492). The presence of TNI-autoantibodies in plasma is associated with an improved survival in patients with chronic DCM, but not ICM. This might possibly indicate a prophylactic effect of TNI-autoantibodies in this subgroup of patients, encouraging further studies into possible protective effects of antibodies against certain cardiac target structures.
Journal: Basic Research in Cardiology - BASIC RES CARDIOL , vol. 106, no. 1, pp. 25-35, 2011
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    • ...In this issue of the Journal, Doesch et al. [5] present data on the impact of autoantibodies to troponin I (TNI) in chronic dilated and ischemic cardiomyopathy...
    • ...The study by Doesch et al. [5] clearly contrasts with most experimental and clinical data published until now...
    • ...Why does the present study fail to support most of the published data? Is it justified to conclude from the present data that TNI antibodies are unexpectedly protective in DCM? To begin, one potential strength of the study by Doesch et al. [5] is the high number of patients included into this monocentric analysis...

    Stephan B. Felix. Editorial on the manuscript entitled “Impact of Troponin I-Autoantibod...

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