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European Heart Journal 1994 15(11):1494-1499;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

The significance of anticardiolipin antibodies and anti-heart muscle antibodies for the diagnosis of postpericardiotomy syndrome

C. BARTELS*,, R. HÖNIG{dagger}, G. BURGER{dagger}, V. DIEHL{dagger} and R. DE VIVIE*

*Department of Cardiothoracic and Vascular Surgery, Medical Center Cologne, Germany
{dagger}Department of Internal Medicine, University of Cologne, Medical Center Cologne, Germany

Received 29 December 1994; revised 12 April 1994; .

Correspondence. C. Bartels, MD, Krankenhaus Porz am Rhein, Teaching Hospital, University of Cologne, Department of Vascular Surgery, Urbacher Weg 19, 51149 Cologne, Germany.

Abstract

Postpericardiotomy syndrome (PPS) is a frequent complication after cardiac surgery. In a recent study, elevated anticardiolipin antibody (ACLA) titres were observed in patients with PPS. Tlie value of anti-heart muscle antibodies (AHA) for the diagnosis of PPS remains controversial. Therefore, a prospective double-blind study was performed to test the sensitivity and specificity of ACLA and AHA for the diagnosis of PPS.

ACLA titres (ELISA) and AHA, elevated by immunofluorescence, the clinical course and routine laboratory parameters were assessed in 57 patients before and after elective cardiac surgery.

ACLA increased and AHA first appeared after surgery in patients both with and without PPS. The sensitivities of a≥1.5-fold increase in IgM-ACLA titres, of a ≥2-fold increase in IgG-ACLA titres and of the occurrence of AHA ≥2+ for the diagnosis of PPS were 60%, 20% and 20%. The respective specificities were 43%, 79% and 85%.

Thus, after cardiac surgery, increased ACLA titres and the occurrence of AHA, as assessed by immunofluorescence, may only contribute to the diagnosis of PPS to a limited extent.

Key Words: Postpericardiotomy syndrome • anti-heart muscle antibodies • anticardiolipin antibody • cardiac surgery


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