Association among β2-adrenergic receptor autoantibodies and proximal left anterior descending artery lesions in patients with initial ST-segment elevation myocardial infarction

Background: β₂ -adrenergic receptor autoantibody (β₂ -AA) are widely present in patients with many different types of cardiovascular diseases. Proximal left anterior descending (LAD) artery lesions are associated with adverse prognostic events in patients with ST-segment elevation myocardial infarction (STEMI).

Hypothesis: β₂ -AA is associated with the presence of proximal LAD lesions in patients with STEMI.

Methods: A cohort of 153 patients with STEMI who underwent primary percutaneous coronary intervention (PPCI) was enrolled in the study. Baseline characteristics were compared between the proximal LAD group (n = 62) and the nonproximal LAD group (n = 91). Admission serum of patients was collected to detect the level of β₂ -AA. Data for echocardiogram within 24 hours after PPCI and at the 6-month follow-up were recorded.

Results: The optical density values and positive rates of β₂ -AA in the proximal LAD group were higher than those in the nonproximal LAD group (p < 0.05). β₂ -AA positively correlated with high sensitivity C-reactive protein and peak N-terminal pro-B type natriuretic peptide levels in the proximal LAD group, but those were not relevant in the nonproximal LAD group. Multivariate logistic regression analysis revealed that high β₂ -AA levels was independently associated with the presence of proximal LAD lesions in patients with STEMI. Furthermore, a receiver operating characteristic curve was used to show the efficiency of β₂ -AA levels to detect proximal LAD lesions, and the AUC of the β2-AA OD value was 0.658 (95% confidence interval 0.568-0.749; p = 0.001).

Conclusions: The STEMI patients with high β₂ -AA levels had a greater possibility having proximal LAD lesions.