Persistent high levels of plasma oxidized low-density lipoprotein after acute myocardial infarction predict stent restenosis.
OBJECTIVE
Recently, elevated levels of plasma oxidized low-density lipoprotein (LDL) have been shown to relate to plaque instability in human atherosclerotic lesions. We investigated prospectively patients admitted with acute myocardial infarction (AMI) who underwent primary coronary stenting to evaluate whether the 6-month outcome could be predicted by measuring plasma oxidized LDL (ox-LDL) levels at the time of hospital discharge.


RESULTS
Plasma ox-LDL levels were measured in 102 patients with AMI undergoing primary coronary stenting using a highly sensitive ELISA method. Measurements were taken on admission and at discharge, and the findings related to the clinical outcome. At 6-month follow-up, angiographic stent restenosis occurred in 25 (25%) of the 102 AMI patients. Plasma ox-LDL levels at discharge were significantly (P=0.0074) higher in the restenosis group than those in the no-restenosis group (1.03+/-0.65 versus 0.61+/-0.34 ng/5 microg LDL protein). Multiple regression analysis showed that only plasma ox-LDL levels at discharge were a statistically significant independent predictor for late lumen loss after stenting (beta=0.645; P<0.0001).


CONCLUSIONS
This prospective study demonstrates that persistence of an increased level of plasma ox-LDL at discharge is a strong independent predictor of stent restenosis at 6-month follow-up in AMI patients.
Naruko
Takahiko
T
Department of Cardiology, Osaka City General Hospital, Japan.
Ueda
Makiko
M
Ehara
Shoichi
S
Itoh
Akira
A
Haze
Kazuo
K
Shirai
Nobuyuki
N
Ikura
Yoshihiro
Y
Ohsawa
Masahiko
M
Itabe
Hiroyuki
H
Kobayashi
Yoshiki
Y
Yamagishi
Hiroyuki
H
Yoshiyama
Minoru
M
Yoshikawa
Junichi
J
Becker
Anton E
AE
D000368:Aged; D015415:Biomarkers; D023903:Coronary Restenosis / Q000097:blood* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D015607:Stents
D015415:Biomarkers; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein