Small coronary calcium deposits and elevated plasma levels of oxidized low density lipoprotein are characteristic of acute myocardial infarction.
OBJECTIVE
Predictions of the onset of acute myocardial infarction (AMI) in high risk individuals are of great clinical importance. Among various risk factors, elevated levels of oxidized low density lipoprotein (ox-LDL) in plasma have been shown to reflect unstable coronary plaques. Coronary calcification is a common finding in the elderly, however, its clinical implications as a risk factor for plaque rupture are controversial. This study was designed to investigate the clinical implications of plasma ox-LDL levels and coronary calcification detected by electron-beam computed tomography (EBCT), by comparing patients with AMI with those with stable angina pectoris (SAP).


METHODS
We measured plasma ox-LDL levels in AMI (n=34) and SAP (n=49) patients. In addition, a coronary calcium score was quantified with the Agatston system. The total coronary calcium score (TCS) was defined as the sum of the scores for each lesion.


RESULTS
TCS and total calcium area were significantly smaller in patients with AMI than in those with SAP. On the other hand, plasma ox-LDL levels were significantly higher in AMI patients than in SAP patients (p<0.0005).


CONCLUSIONS
These results suggest that a combined assessment of coronary calcium and plasma ox-LDL levels may be useful for screening patients with unstable coronary plaques.
Ehara
Shoichi
S
Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Naruko
Takahiko
T
Shirai
Naoya
N
Itoh
Akira
A
Hai
Eishu
E
Sugama
Yoshimi
Y
Ikura
Yoshihiro
Y
Ohsawa
Masahiko
M
Okuyama
Takuhiro
T
Shirai
Nobuyuki
N
Yamashita
Hajime
H
Itabe
Hiroyuki
H
Haze
Kazuo
K
Yoshiyama
Minoru
M
Ueda
Makiko
M
D000368:Aged; D002114:Calcinosis / Q000175:diagnosis / Q000473:pathology*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000473:pathology*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
D008077:Lipoproteins, LDL