Birnie et al. (2005). Increased titres of anti-human heat shock protein 60 predict an adverse one year prognosis in patients with acute cardiac chest pain Heart 91: 1148–1153

Previous studies have shown that titers of antibodies to human heat shock protein 60 (anti-huHSP60) or mycobacterial heat shock protein 65 (anti-mHSP65) are linked with progression of carotid atherosclerosis and clinical outcomes. In what is claimed to be the first study to assess the prognostic implications of anti-huHSP60 titers in a population of patients with unstable angina, Birnie et al. have now investigated whether titers of anti-huHSP60 and anti-mhsp65 can predict adverse clinical outcome in patients with acute chest pain of suspected cardiac ischemic origin.

In this prospective study, venous blood samples were obtained from 588 participants, and their titers of anti-mhsp65 and anti-huHSP60 measured. Patients were followed up for a mean period of 304 days and the following endpoint outcomes were recorded: coronary heart disease death; nonfatal myocardial infarction; coronary artery bypass grafting; percutaneous transluminal coronary angioplasty; angiogram; and readmission with further cardiac chest pain.

The risk of an adverse 1-year prognosis increased by about 50% for patients with titers of anti-huHSP60 greater than 16 U/l compared with those with lower titers. This trend was still evident after adjustment for the established cardiovascular risk factors of age, hypertension, diabetes and smoking. Titers of anti-mhsp65, however, did not correlate significantly with 1-year clinical outcomes.

The authors conclude that elevated titers of anti-huHSP60 are associated with increased risk of an adverse 1-year prognosis in patients presenting with acute chest pain.