Diagnostic and prognostic value of autoantibodies against beta(1)-adrenoreceptors in patients with heart failure following acute myocardial infarction: A 5-year prospective study

A number of studies have suggested that autoantibodies against beta(1)-adrenoreceptors (beta R-1-AAbs) have an important role in pathophysiological processes of heart failure. The aim of the present study was to determine whether beta R-1-AAbs are implicated in cardiac dysfunction following acute myocardial infarction (AMI) and their association with prognosis. A total of 33 cases with systolic heart failure (SHF), 49 with diastolic heart failure (DHF) and 44 with normal heart function following AMI were recruited. beta R-1-AAbs were detected by ELISA and major adverse cardiac events (MACEs) were recorded during the 5-year follow-up. The positive rate of beta R-1-AAbs in the SHF group (45.5%) was significantly higher compared with that in the DHF (22.4%; P<0.05) and normal (15.9%; P<0.05) groups. The area under the receiver operating characteristics curve for the diagnosis of SHF was 0.630 (95% CI: 0.514-0.747, P=0.026). During a median follow-up period of 51.0 +/- 15.4 months, the positive rate of beta R-1-AAbs in the MACEs group was significantly higher compared with that in the non-MACEs group (P<0.05). Multivariate logistic regression analysis indicated that the left ventricular ejection fraction and diabetes were independent predictors of 5-year MACEs following AMI, whereas beta R-1-AAbs were not. Kaplan-Meier analysis revealed that the cumulative MACEs-free survival rate was the lowest in the SHF group, followed by the DHF and normal groups (P<0.05). Therefore, beta R-1-AAbs were indicated to be of value for early diagnosis of SHF after AMI but not as independent predictors for the prognosis of patients with AMI.