Low levels of IgM antibodies against phosphorylcholine predict development of acute myocardial infarction in a population-based cohort from northern Sweden

Eur J Cardiovasc Prev Rehabil. 2009 Jun;16(3):382-6. doi: 10.1097/HJR.0b013e32832a05df.


Objective: Phosphorylcholine (PC) is one important epitope on oxidized low-density lipoprotein that may play an important role by contributing to the atherogenicity of oxidized low-density lipoprotein. IgM antibodies against PC (anti-PC) are present ubiquitously in the population as natural antibodies. We here determine the association between anti-PC and incidence of myocardial infarction (MI).

Methods: We studied 462 incident cases of first events of MI and 888 age-matched and sex-matched controls identified through 13 years of follow-up (1987-1999) of participants in a population-based study from northern Sweden. Relative risks (RRs) with 95% confidence intervals (CIs) of incident MI with adjustments for age, sex, geographical region, hypertension, diabetes, BMI, smoking habits, s-cholesterol and high-sensitivity C-reactive protein were determined. Anti-PC levels were measured by enzyme-linked immunoassay.

Results: Low anti-PC values were associated with increased risk of MI. Significant associations were found for values below 26.8 U/ml, corresponding to the lowest 25th percentile, and the highest association was seen below 16.9 U/ml. These results remained almost the same after adjustment for confounding factors (RR crude: 1.56, CI: 1.07-2.28 and RR adjusted: 1.69, CI: 1.09-2.54).

Conclusion: Low levels of natural IgM anti-PC could play an important role as risk markers for development of MI. Adjustment for common confounders only marginally affected the RR, suggesting that the addition of IgM anti-PC add independent information to the more traditional risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibodies / blood*
  • Case-Control Studies
  • Cohort Studies
  • Down-Regulation
  • Epitopes
  • Female
  • Humans
  • Immunoglobulin M / blood*
  • Incidence
  • Lipoproteins, LDL / immunology*
  • Logistic Models
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / immunology*
  • Phosphorylcholine / immunology*
  • Population Surveillance
  • Risk Assessment
  • Risk Factors
  • Sweden


  • Antibodies
  • Epitopes
  • Immunoglobulin M
  • Lipoproteins, LDL
  • oxidized low density lipoprotein
  • Phosphorylcholine