title: Circulating oxidized low-density lipoprotein is an independent predictor for cardiac event in patients with coronary artery disease.
abstract: Oxidized low-density lipoprotein (oxLDL) plays a crucial role in the development of atherosclerosis, however, the predictive value of circulating oxLDL for cardiac events (CE) in patients with coronary artery disease (CAD) has remained poorly understood. We prospectively studied 238 consecutive patients with documented CAD for up to 52 months until the occurrence of one of the following cardiac events: cardiac death, nonfatal myocardial infarction (MI), and refractory angina requiring revascularization. The plasma levels of oxLDL were measured by an enzyme-linked immunosorbent assay (ELISA) using the monoclonal antibody, DLH3. The levels of circulating oxLDL were significantly higher in patients with CE than in patients without CE (median 20.3 U/ml versus 17.6 U/ml, P = 0.002). Multivariate Cox models showed that higher level of oxLDL was an independent predictor of developing CE. The adjusted hazard ratios for CE were 3.15 (95% CI 1.47-6.76, P = 0.003) times higher in patients with the highest quartile of oxLDL levels and 1.88 (95% CI 0.90-3.95, P = 0.09) times higher in patients with the third quartile than in those within the lowest quartile. Thus, measurement of circulating oxLDL may be helpful in the assessment of future CE in patients with CAD.
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo 113-8421, Japan. shimakaz@med.juntendo.ac.jp
authors.forename: Kazunori
authors.initials: K
authors.lastname: Shimada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mokuno
authors.forename: Eriko
authors.initials: E
authors.lastname: Matsunaga
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Sumiyoshi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000789:Angina, Unstable / Q000097:blood* / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein