Szczegóły publikacji
Opis bibliograficzny
Antinuclear antibodies as a risk factor for ischemic stroke or death in elderly patients with atrial fibrillation despite anticoagulation / Maksymilian Hanarz, Michał Ząbczyk, Joanna Natorska, Elżbieta POCIASK, Anetta Undas // Clinical Rheumatology ; ISSN 0770-3198 . — 2025 — vol. 44 iss. 10, s. 4415–4424. — Bibliogr. s. 4423–4424, Abstr. — Publikacja dostępna online od: 2025-08-22. -- Letter to the editor: Clinical Rheumatology. - 2025 vol. 44 iss. 12, s. 5165–5166
Autorzy (5)
- Hanarz Maksymilian
- Ząbczyk Michał
- Natorska Joanna
- AGHPociask Elżbieta
- Undas Anetta
Słowa kluczowe
Dane bibliometryczne
| ID BaDAP | 166482 |
|---|---|
| Data dodania do BaDAP | 2026-03-12 |
| Tekst źródłowy | URL |
| DOI | 10.1007/s10067-025-07638-y |
| Rok publikacji | 2025 |
| Typ publikacji | artykuł w czasopiśmie |
| Otwarty dostęp |  |
| Creative Commons | |
| Czasopismo/seria | Clinical Rheumatology |
Abstract
Objective: Antinuclear antibodies (ANA) at low titers of 1:40 may be present in up to 30% of healthy individuals and have been associated with increased cardiovascular mortality, but their role in atrial fibrillation (AF) remains unclear. This study assessed ANA prevalence and its association with outcomes in AF patients. Methods: In a cohort of 240 AF patients on anticoagulant therapy (median age 69, median CHA2DS2-VASc = 4), without any ANA-related autoimmune diseases, we determined ANA (positive if > 20 ELISA units [EU]) along with antiphospholipid antibodies in accordance to ACR/EULAR (ACR/EULAR-aPL). During a median follow-up of 52 months, ischemic stroke (IS), transient ischemic attack (TIA), cardiovascular (CV) death, major bleeding, and a composite endpoint (defined as IS, TIA, or CV death) were recorded. Results: 43 patients (17.9%) were positive for ANA (mean 22.9 EU), including 20 (46.5%) with positive ACR/EULAR-aPL. ANA-positive patients were older (by 9.9 years), predominantly female (65.1%), and had higher CHA2DS2-VASc scores (median 5 vs 4; all P < 0.001). IS or CV death occurred in 30 patients (12.5%, 3% per year) who were ANA positive. ANA positivity was associated with the composite endpoint occurrence (odds ratio [OR] = 2.84, 95% confidence interval [CI] 1.21–6.65). Furthermore, the presence of both ANA and ACR/EULAR-aPL positivity significantly increased the likelihood of the composite endpoint (OR = 4.85, 95%CI 1.75–13.43). Conclusions: Positive ANA coexisting with ACR/EULAR-aPL may contribute to the failure of oral anticoagulation in AF patients, highlighting a potential role of autoimmune mechanisms in thromboembolism associated with this common arrhythmia.
