Antiphospholipid Antibodies in Young Adults with Myocardial Infarction

Abstract

Aim: This study aimed to assess the prevalence of antiphospholipid antibodies in young (<45years) patients with MI (myocardial infarction) and to find an association between antiphospholipid antibodies and conventional risk factors of MI. Study Design: Case control study. Place and Duration of Study: Departments of Pathology and Medicine, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi between November 2018 and March 2020. Methodology: Forty young MI (<45years) patients and 30 age matched controls were included in the study. Venous blood was collected for Complete blood counts (Automated hematology analyzer), Prothrombin time, Activated partial thromboplastin time (Automated coagulometer), test for Lupus anticoagulant (ISTH criteria), Anticardiolipin antibodies IgG and IgM and Anti-β2-glycoprotein I IgG (ELISA) were done in all patients and controls. SPSS (20) software was used for mean, standard deviation, and median values of the quantitative parameters and for all qualitative parameters, their frequencies were obtained. Positivity for antiphospholipid antibodies were expressed in percentages. Association between antiphospholipid antibodies and other risk factors was done using Chi-square test and Fisher’s exact test. Odds Ratio was calculated for the various risk factors.  P less than 0.05 was considered statistically significant. Results: Conventional risk factors like smoking, obesity, diabetes mellitus, hypertension and dyslipidemia were present in all patients. Antiphospholipid antibodies were detected in 6 (15%) patients and 1 (3.3%) control. Multiple conventional risk factors were present in antiphospholipid antibodies positive patients. No significant association was seen between antiphospholipid antibodies and conventional risk factors of MI. Conclusion: The study identified antiphospholipid antibodies in 15% young MI patients all of whom also had conventional risk factors. Hence a work-up for these antibodies may be included in these patients.