Abstract 12063: Serum Immunoglobulin G4 Level Independently Predicts Future Adverse Cardiac Events Over Long-Term Follow-Up
Objective: Immunoglobulin G4 (IgG4)-related disease has been suggested to affect the cardiovascular system. By contrast, the relationship between IgG4-related immuno-inflammation and the progression of coronary atherosclerosis remains unclear. We analyzed whether serum IgG4 level predicts future cardiovascular events.
Methods: Serum levels of IgG4 were measured in 366 patients (256 males; mean age, 66.8 ± 10.4 years) without previous coronary interventions who underwent coronary angiography (CAG) between October 2005 and September 2008. Furthermore, among a total of 161 patients without coronary artery disease (CAD) judged by CAG, major adverse cardiac events (MACE), including death, non-fatal myocardial infarction, unstable angina, and heart failure requiring hospitalization, were assessed over a median follow-up of 2312 days (interquartile range [IR] 411-2831 days).
Results: The median of serum IgG4 levels was significantly higher in patients with CAD (37.2 mg/dL, IR 21.3-62.4) than in those without (30.5 mg/dL, IR 15.8-50.3, P=0.006). Among patients without CAD, MACE occurred in 21 (13.0%) patients during the follow-up period. Patients in the fourth quartile of IgG4 (≥50.4 mg/dL) had significantly higher risk of MACE compared with those in the first to third quartiles of IgG4 (log-rank test, P<0.001). After adjustment for age, gender, estimated glomerular filtration rate (eGFR), hypertension, dyslipidemia, diabetes, smoking, and serum levels of high-sensitivity C-reactive protein (hsCRP) by Cox regression analysis, the fourth IgG4 quartile remained an independent predictor of MACE with a hazard ratio of 3.78 (95% confidence interval 1.50-9.51, P=0.005).
Conclusions: Elevated serum IgG4 level is a significant predictor of MACE independent of traditional cardiovascular risk factors, even among individuals without apparent IgG4-related disease. IgG4-related immuno-inflammation may play a role in the development of cardiac remodeling.
Author Disclosures: A. Sakamoto: None. N. Ishizaka: None. J. Ando: None. R. Nagai: None. I. Komuro: None.
- © 2014 by American Heart Association, Inc.