Investigation of MDA-LDL (malondialdehyde-modified low-density lipoprotein) as a prognostic marker for coronary artery disease in patients with type 2 diabetes mellitus.
BACKGROUND
Although increased circulating levels of malondialdehyde-modified low-density lipoprotein (MDA-LDL) are associated with coronary artery disease (CAD), there is no direct evidence that increased MDA-LDL is a prognostic factor for CAD.


METHODS
Forty-two patients (20 diabetic and 22 non-diabetic patients) who underwent percutaneous coronary intervention (PCI) were enrolled, and their baseline MDA-LDL levels were determined by immunoassay. Follow-up coronary angiography was performed at 2 to 7 months post-PCI. The patients were then divided into 2 groups, with in-stent restenosis (ISR) (n=13) and without ISR (n=29), and the baseline MDA-LDL levels were compared. We also studied 34 diabetics with CAD for up to 57 months until the onset of the next coronary event.


RESULTS
In the diabetic patients, the mean MDA-LDL level was significantly higher in those with ISR than in those without ISR (151+/-61 vs. 90+/-26 U/l, p=0.010). A baseline MDA-LDL value of 110 U/l for differentiating between diabetics with and without ISR was defined as the cut-off value. Kaplan-Meier analysis demonstrated that a circulating MDA-LDL of ≥ 110 U/l correlated significantly with a higher prevalence of cardiac events than MDA-LDL <110 U/l (p=0.032).


CONCLUSIONS
Circulating MDA-LDL is a useful prognostic marker for future cardiac event in diabetic patients with CAD.
Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan. Electronic address: kotani@sekisui.com.
Kazuo
K
Kotani
Department of Internal Medicine, Chiba Cerebral and Cardiovascular Center, 575 Tsurumai, Ichihara, Chiba 290-0512, Japan; Department of Internal Medicine, Matsudo Municipal Hospital, 4005 Kamihongo, Matsudo, Chiba 271-8511, Japan.
Jun
J
Tashiro
Department of Internal Medicine, Chiba Cerebral and Cardiovascular Center, 575 Tsurumai, Ichihara, Chiba 290-0512, Japan; Department of Internal Medicine, Matsudo Municipal Hospital, 4005 Kamihongo, Matsudo, Chiba 271-8511, Japan.
Kenya
K
Yamazaki
Department of Internal Medicine, Chiba Cerebral and Cardiovascular Center, 575 Tsurumai, Ichihara, Chiba 290-0512, Japan.
Yoshitake
Y
Nakamura
Department of Internal Medicine, Chiba Cerebral and Cardiovascular Center, 575 Tsurumai, Ichihara, Chiba 290-0512, Japan.
Akira
A
Miyazaki
Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, 564-1, Shimoshizu Sakura, Chiba 285-8741, Japan.
Hideaki
H
Bujo
Department of Clinical Cell Biology, Chiba University Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.
Yasushi
Y
Saito
Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan.
Takashi
T
Kanno
Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan.
Masato
M
Maekawa
D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008315:Malondialdehyde / Q000097:blood*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis
D015415:Biomarkers; D008077:Lipoproteins, LDL; D008315:Malondialdehyde
Cardiac event; Diabetes mellitus; Malondialdehyde-modified LDL; Oxidized LDL; Prognostic marker; Restenosis