{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:56:09Z","timestamp":1788400569032,"version":"build-2803163510"},"reference-count":52,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004881","name":"Mexican Institute of Social Security","doi-asserted-by":"publisher","award":["FIS\/IMSS\/PROT\/MD19\/1892"],"award-info":[{"award-number":["FIS\/IMSS\/PROT\/MD19\/1892"]}],"id":[{"id":"10.13039\/501100004881","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Universidad Aut\u00f3noma de Guadalajara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Acute coronary syndrome (ACS), driven by inflammation and thrombosis, remains a leading cause of morbidity globally. While traditional risk scores are useful, the prognostic value of combining inflammatory and autoimmune biomarkers remains understudied. This study aimed to evaluate the predictive role of high-sensitivity C-reactive protein (hs-CRP), platelet factor 4 (PF4), D-dimer, and antiphospholipid antibodies (anticardiolipin and anti-\u03b22-glycoprotein I) for the development of major adverse cardiovascular events (MACE) in patients with ACS. We conducted a prospective cohort study at a tertiary referral center in Mexico. A total of 103 patients admitted with confirmed ACS were included. Blood samples were collected upon admission to measure biomarker levels. Participants were followed for 30 days. The primary outcome was the occurrence of MACE, defined as reinfarction, death, percutaneous coronary intervention, or bypass surgery. Multivariate logistic regression analysis was performed to identify independent predictors, adjusting for age, smoking, and comorbidities. MACE occurred in 51.4% of participants. Patients with adverse outcomes were significantly older and had longer hospital stays (p &lt; 0.05). In the biomarker analysis, PF4 and hs-CRP demonstrated high sensitivity (98%) but low specificity. In the multivariate analysis, IgG anti-\u03b22-glycoprotein I (p &lt; 0.001) and D-dimer (p = 0.024) emerged as significant independent predictors of MACE. Conversely, IgM isotypes did not show independent predictive value. Beyond traditional risk factors, markers of coagulation (D-dimer) and autoimmunity (IgG anti-\u03b22-glycoprotein I) are independent predictors of short-term adverse events in ACS patients. Integrating these multidomain biomarkers into clinical assessment may enhance risk stratification and prognostic accuracy.<\/jats:p>","DOI":"10.3390\/ijms27052476","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T10:16:12Z","timestamp":1773051372000},"page":"2476","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multidomain Biomarkers as Predictors of Cardiovascular Risk in Acute Coronary Syndrome: A Prospective Evaluation"],"prefix":"10.3390","volume":"27","author":[{"given":"Guadalupe Estela","family":"Gavil\u00e1nez-Ch\u00e1vez","sequence":"first","affiliation":[{"name":"Servicio de Urgencias, Hospital General Regional 46, Instituto Mexicano del Seguro Social, Guadalajara 44910, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6508-9657","authenticated-orcid":false,"given":"Maria G.","family":"Zavala-Cerna","sequence":"additional","affiliation":[{"name":"Laboratorio de Investigaci\u00f3n en Inmunolog\u00eda, Decanato Medicina, Universidad Aut\u00f3noma de Guadalajara, Zapopan 45129, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8751-2994","authenticated-orcid":false,"given":"Sandra","family":"Guzm\u00e1n-Silahua","sequence":"additional","affiliation":[{"name":"Unidad de Investigaci\u00f3n Epidemiol\u00f3gica y en Servicios de Salud, Centro Medico Nacional de Occidente, \u00d3rgano de Operaci\u00f3n Administrativa DesconcentradaJalisco, Instituto Mexicano del Seguro Social, Guadalajara 44340, Mexico"},{"name":"Programa Internacional de Medicina, Universidad Aut\u00f3noma de Guadalajara, Zapopan 45129, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz Rebeca","family":"Rodr\u00edguez-Rivera","sequence":"additional","affiliation":[{"name":"Servicio de Urgencias, Hospital General Regional 46, Instituto Mexicano del Seguro Social, Guadalajara 44910, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristo F.","family":"Urzua-Ortega","sequence":"additional","affiliation":[{"name":"Laboratorio de Investigaci\u00f3n en Inmunolog\u00eda, Decanato Medicina, Universidad Aut\u00f3noma de Guadalajara, Zapopan 45129, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto Germ\u00e1n","family":"Cardona-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Programa de Doctorado en Farmacolog\u00eda, Departamento de Fisiolog\u00eda, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4812-1090","authenticated-orcid":false,"given":"Eduardo","family":"Chuquiure-Valenzuela","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiol\u00f3gia \u201cIgnacio Chavez\u201d, Ciudad de Mexico 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5138-8063","authenticated-orcid":false,"given":"Benjam\u00edn","family":"Rubio-Jurado","sequence":"additional","affiliation":[{"name":"Unidad de Investigaci\u00f3n Epidemiol\u00f3gica y en Servicios de Salud, Centro Medico Nacional de Occidente, \u00d3rgano de Operaci\u00f3n Administrativa DesconcentradaJalisco, Instituto Mexicano del Seguro Social, Guadalajara 44340, Mexico"},{"name":"Departamento Cl\u00ednico de Hematolog\u00eda, Divisi\u00f3n Onco-Hematologia, Unidad Medica de Alta Especialidad, Hospital de Especialidades, Centro M\u00e9dico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3061-521X","authenticated-orcid":false,"given":"Arnulfo Hern\u00e1n","family":"Nava-Zavala","sequence":"additional","affiliation":[{"name":"Unidad de Investigaci\u00f3n Epidemiol\u00f3gica y en Servicios de Salud, Centro Medico Nacional de Occidente, \u00d3rgano de Operaci\u00f3n Administrativa DesconcentradaJalisco, Instituto Mexicano del Seguro Social, Guadalajara 44340, Mexico"},{"name":"Programa Internacional de Medicina, Universidad Aut\u00f3noma de Guadalajara, Zapopan 45129, Mexico"},{"name":"Departamento de Inmunolog\u00eda y Reumatolog\u00eda del Hospital General de Occidente, Secretar\u00eda de Salud Jalisco, Guadalajara 45170, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Odeberg, J., Halling, A., Ringborn, M., Freitag, M., Persson, M.L., Vaara, I., Rastam, L., Odeberg, H., and Lindblad, U. (2025). Markers of inflammation predicts long-term mortality in patients with acute coronary syndrome\u2014A cohort study. BMC Cardiovasc. Disord., 25.","DOI":"10.1186\/s12872-025-04608-9"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e100622205865","DOI":"10.2174\/1573403X18666220610164946","article-title":"Diagnostic Role and Methods of Detection of Cardiac Troponins: An Opinion from Historical and Current Points of View","volume":"19","year":"2023","journal-title":"Curr. Cardiol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1007\/s11886-014-0492-5","article-title":"Universal MI definition update for cardiovascular disease","volume":"16","author":"White","year":"2014","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"85","DOI":"10.7326\/0003-4819-148-2-200801150-00003","article-title":"Biomarkers of inflammation and thrombosis as predictors of near-term mortality in patients with peripheral arterial disease: A cohort study","volume":"148","author":"Vidula","year":"2008","journal-title":"Ann. Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1161\/ATVBAHA.108.179705","article-title":"Inflammation in atherosclerosis","volume":"32","author":"Libby","year":"2012","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1161\/STROKEAHA.118.023954","article-title":"Antiplatelet Therapy in Ischemic Stroke and Transient Ischemic Attack","volume":"50","author":"Hackam","year":"2019","journal-title":"Stroke"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"9637","DOI":"10.2147\/JIR.S528161","article-title":"Prognostic Role of Inflammatory Hematologic Indices in Predicting Acute Coronary Syndrome in Elderly Patients with Chronic Coronary Syndrome","volume":"18","author":"Bao","year":"2025","journal-title":"J. Inflamm. Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Li, Q., Ma, X., Shao, Q., Yang, Z., Wang, Y., Gao, F., Zhou, Y., Yang, L., and Wang, Z. (2022). Prognostic Impact of Multiple Lymphocyte-Based Inflammatory Indices in Acute Coronary Syndrome Patients. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.811790"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Cao, F., Jiang, J.-J., Zhang, G., Liu, J., Xiao, P., Tian, Y., Zhang, W., Zhang, S., Hou, F., and Bao, Z.-W. (2025). Prognostic value of inflammatory markers for all-cause mortality in patients with acute myocardial infarction in the coronary care unit: A retrospective study based on MIMIC-IV database. Front. Cardiovasc. Med., 12.","DOI":"10.3389\/fcvm.2025.1439650"},{"key":"ref_10","first-page":"e152","article-title":"Inflammatory biomarkers in acute coronary syndromes: Part II: Acute-phase reactants and biomarkers of endothelial cell activation","volume":"113","author":"Armstrong","year":"2006","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"37S","DOI":"10.1016\/S0735-1097(02)02953-4","article-title":"C-reactive protein and other inflammatory risk markers in acute coronary syndromes","volume":"41","author":"Blake","year":"2003","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","first-page":"16113","article-title":"Fibrin clot properties in coronary artery disease: New determinants and prognostic markers","volume":"131","author":"Larsen","year":"2021","journal-title":"Pol. Arch. Intern. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1055\/s-0040-1718923","article-title":"Fibrinolysis in Acute and Chronic Cardiovascular Disease","volume":"47","author":"Kietsiriroje","year":"2021","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Sproston, N.R., and Ashworth, J.J. (2018). Role of C-Reactive Protein at Sites of Inflammation and Infection. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.00754"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"671","DOI":"10.7754\/Clin.Lab.2024.240941","article-title":"Predictive Value of Serum D-Dimer and Prothrombin Time for Adverse Events in Patients with Acute Myocardial Infarction","volume":"71","author":"Yang","year":"2025","journal-title":"Clin. Lab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12959-021-00281-y","article-title":"Prognostic Value of D-dimer in patients with acute coronary syndrome treated by percutaneous coronary intervention: A retrospective cohort study","volume":"19","author":"Chen","year":"2021","journal-title":"Thromb. J."},{"key":"ref_17","first-page":"300","article-title":"The Prognostic Value of D-Dimer in Patients with Acute Myocardial Infarction: A Retrospective Longitudinal Cohort Study in Taiwan","volume":"40","author":"Yu","year":"2024","journal-title":"Acta Cardiol. Sin."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Iqbal, J., Wu, H.X., Wu, Y.X., Jiang, H.L., Li, L., Zhou, X.Y., Bu, Y.H., and Zhou, H.D. (J. Adv. Res., 2026). MetsObesity: A novel classification system for predicting 15-year cardiovascular risk in the UK Biobank population, J. Adv. Res., in press.","DOI":"10.1016\/j.jare.2026.01.050"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s12959-021-00354-y","article-title":"D-dimer for risk stratification and antithrombotic treatment management in acute coronary syndrome patients: Asystematic review and metanalysis","volume":"19","author":"Biccire","year":"2021","journal-title":"Thromb. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijcard.2020.02.010","article-title":"D-dimer level predicts in-hospital adverse outcomes after primary PCI for ST-segment elevation myocardial infarction","volume":"305","author":"Huang","year":"2020","journal-title":"Int. J. Cardiol."},{"key":"ref_21","first-page":"1478","article-title":"Acute myocardial infarction in a man without coronary atheromatosis and antiphospholipid syndrome: Report of one case","volume":"137","author":"Jurado","year":"2009","journal-title":"Rev. Med. Chile"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1536\/ihj.46.631","article-title":"Association between anticardiolipin antibodies and recurrent cardiac events in patients with acute coronary syndrome","volume":"46","author":"Gurlek","year":"2005","journal-title":"Int. Heart J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4314\/pamj.v8i1.71062","article-title":"Acute myocardial infarction in young adults with antiphospholipid syndrome: Report of two cases and literature review","volume":"8","author":"Abid","year":"2011","journal-title":"Pan Afr. Med. J."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Barreno-Rocha, S.G., Guzman-Silahua, S., Rodriguez-Davila, S.D., Gavilanez-Chavez, G.E., Cardona-Munoz, E.G., Riebeling-Navarro, C., Rubio-Jurado, B., and Nava-Zavala, A.H. (2022). Antiphospholipid Antibodies and Lipids in Hematological Malignancies. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23084151"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1191\/0961203304lu1011oa","article-title":"Antiphospholipid antibodies in acute coronary syndrome","volume":"13","author":"Veres","year":"2004","journal-title":"Lupus"},{"key":"ref_26","first-page":"364","article-title":"Serum autoantibodies against human oxidized low-density lipoproteins are inversely associated with severity of coronary stenotic lesions calculated by Gensini score","volume":"18","author":"Che","year":"2011","journal-title":"Cardiol. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.cca.2009.06.005","article-title":"High circulating autoantibodies against human oxidized low-density lipoprotein are related to stable and lower titers to unstable clinical situation","volume":"406","author":"Santos","year":"2009","journal-title":"Clin. Chim. Acta"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.recesp.2013.12.013","article-title":"Complementary, alternative, and putative nontroponin biomarkers of acute coronary syndrome: New resources for future risk assessment calculators","volume":"67","author":"Millard","year":"2014","journal-title":"Rev. Esp. Cardiol. (Engl. Ed.)"},{"key":"ref_29","unstructured":"Ord\u00f3\u00f1ez, J., and Gen\u00eds, A.B. (2015). Cien A\u00f1os de Historia del Infarto de Miocardio Contada a Trav\u00e9s de sus Biomarcadores, Elsevier."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Stanojkovic, A., Mrdovic, I., Tosic, I., Matic, D., Savic, L., Petrovic, J., Cirkovic, A., Milosevic, A., Srdic, M., and Kostic, N. (2025). Prognostic Value of the RISK-PCI Score in Patients with Non-ST-Segment Elevation Acute Myocardial Infarction. J. Clin. Med., 14.","DOI":"10.3390\/jcm14082727"},{"key":"ref_31","first-page":"10","article-title":"Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort Study","volume":"55","author":"Ginanjar","year":"2023","journal-title":"Acta Med. Indones."},{"key":"ref_32","first-page":"e368","article-title":"2021 AHA\/ACC\/ASE\/CHEST\/SAEM\/SCCT\/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"144","author":"Gulati","year":"2021","journal-title":"Circulation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3904\/kjim.2018.381","article-title":"Current status of acute myocardial infarction in Korea","volume":"34","author":"Kim","year":"2019","journal-title":"Korean J. Intern. Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Doggen, C.J., Zwerink, M., Droste, H.M., Brouwers, P.J., van Houwelingen, G.K., van Eenennaam, F.L., and Egberink, R.E. (2016). Prehospital paths and hospital arrival time of patients with acute coronary syndrome or stroke, a prospective observational study. BMC Emerg. Med., 16.","DOI":"10.1186\/s12873-015-0065-y"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/00045632221100347","article-title":"Rapid diagnostic strategies using high sensitivity troponin assays: What is the evidence and how should they be implemented?","volume":"60","author":"Collinson","year":"2023","journal-title":"Ann. Clin. Biochem."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e007252","DOI":"10.1161\/JAHA.117.007252","article-title":"Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI Study","volume":"6","author":"Cediel","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1080\/10408363.2017.1285268","article-title":"High-sensitivity cardiac troponin assays: From improved analytical performance to enhanced risk stratification","volume":"54","author":"Kozinski","year":"2017","journal-title":"Crit. Rev. Clin. Lab. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"9713326","DOI":"10.1155\/2022\/9713326","article-title":"High-Sensitivity Troponin: A Review on Characteristics, Assessment, and Clinical Implications","volume":"2022","author":"Lazar","year":"2022","journal-title":"Dis. Markers"},{"key":"ref_39","first-page":"795","article-title":"HEART, TIMI, and GRACE Scores for Prediction of 30-Day Major Adverse Cardiovascular Events in the Era of High-Sensitivity Troponin","volume":"114","author":"Torralba","year":"2020","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Badimon, L., Pena, E., Arderiu, G., Padro, T., Slevin, M., Vilahur, G., and Chiva-Blanch, G. (2018). C-Reactive Protein in Atherothrombosis and Angiogenesis. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.00430"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"S277","DOI":"10.1194\/jlr.R800063-JLR200","article-title":"Regulation of macrophage function in inflammation and atherosclerosis","volume":"50","author":"Shibata","year":"2009","journal-title":"J. Lipid Res."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Kaura, A., Hartley, A., Panoulas, V., Glampson, B., Shah, A.S.V., Davies, J., Mulla, A., Woods, K., Omigie, J., and Shah, A.D. (2022). Mortality risk prediction of high-sensitivity C-reactive protein in suspected acute coronary syndrome: A cohort study. PLoS Med., 19.","DOI":"10.1371\/journal.pmed.1003911"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1001\/jamacardio.2019.0179","article-title":"Association of Initial and Serial C-Reactive Protein Levels With Adverse Cardiovascular Events and Death After Acute Coronary Syndrome: A Secondary Analysis of the VISTA-16 Trial","volume":"4","author":"Mani","year":"2019","journal-title":"JAMA Cardiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/CRD.0000000000000604","article-title":"Baseline High-Sensitivity C-Reactive Protein as a Predictor of Adverse Clinical Events in Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Meta-Analysis","volume":"33","author":"Yang","year":"2025","journal-title":"Cardiol. Rev."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1080\/09537104.2019.1665641","article-title":"Modulators of platelet function in aging","volume":"31","author":"Iyer","year":"2020","journal-title":"Platelets"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.thromres.2009.11.023","article-title":"Role of the platelet chemokine platelet factor 4 (PF4) in hemostasis and thrombosis","volume":"125","author":"Kowalska","year":"2010","journal-title":"Thromb. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3989","DOI":"10.1016\/j.jtha.2025.07.014","article-title":"Biomarkers of in vivo platelet activation in coronary artery disease: A systematic review and meta-analysis: Communication from the SSC of the ISTH","volume":"23","author":"Brambilla","year":"2025","journal-title":"J. Thromb. Haemost."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1093\/cvr\/cvx112","article-title":"A role for autoantibodies in atherogenesis","volume":"113","author":"Iseme","year":"2017","journal-title":"Cardiovasc. Res."},{"key":"ref_49","first-page":"331","article-title":"Anticuerpos anti-\u03b22-glucoproteina I y lupus eritematoso sistemico","volume":"119","author":"Almeida","year":"2002","journal-title":"Med. Cl\u00edn."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1002\/art.42624","article-title":"The 2023 ACR\/EULAR Antiphospholipid Syndrome Classification Criteria","volume":"75","author":"Barbhaiya","year":"2023","journal-title":"Arthritis Rheumatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1309\/AJCP2FJUT2YZGITK","article-title":"Newer antiphospholipid antibodies predict adverse outcomes in patients with acute coronary syndrome","volume":"132","author":"Greco","year":"2009","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1001\/jama.2024.21972","article-title":"World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants","volume":"333","author":"Association","year":"2025","journal-title":"JAMA"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/5\/2476\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T10:20:37Z","timestamp":1773051637000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/5\/2476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,7]]},"references-count":52,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["ijms27052476"],"URL":"https:\/\/doi.org\/10.3390\/ijms27052476","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,7]]}}}