Key result
Plasma levels of oxidized LDL were significantly elevated in patients with unstable angina (161.2) compared to stable angina (119.2) and healthy controls (67.0, p<0.001).
Why the study?
Data concerning the evaluation of circulating oxidized LDL and autoantibodies against them as biochemical markers in clinical practice for coronary artery disease diagnosis and severity are very limited.
Do plasma levels of ox-LDL, anti-oxLDL antibodies, and homocysteine correlate with the diagnosis and severity of coronary artery disease?
Cross-Sectional (n=273)
Do plasma levels of ox-LDL, anti-oxLDL antibodies, and homocysteine correlate with the diagnosis and severity of coronary artery disease?
Absolute Event Rate: 161.2% vs 119.2%
p-value: p=<0.001
Circulating oxLDL and anti-oxLDL antibodies are significantly elevated in patients with coronary artery disease, with levels correlating with the clinical severity of angina.
Oxidized LDL elevation may signal unstable angina; leaves open its role in risk stratification or therapy guidance.
The oxidative hypothesis of atherosclerosis proposes that oxidative modification of low density lipoprotein (LDL) plays a critical role in atherogenesis. The evaluation of LDL oxidation in vivo is therefore very important. However, data concerning the evaluation of the above biochemical marker is very limited in clinical practice. This study was conducted to test the hypothesis that plasma levels of ox-LDL reflect atherosclerosis and determine the clinical significance in the measurement of circulating ox-LDL and autoantibodies against them as well as their correlation with homocysteine and lipid parameters in the diagnosis and severity of coronary heart disease. A total of 273 individuals were examined: 41 suffering from unstable angina pectoris (UAP), 62 from stable angina pectoris (SAP) and 170 healthy control subjects. We used a sensitive method for detecting ox-LDL that is based on a direct sandwich technique (ELISA) in which two monoclonal antibodies are directed against separate antigenic determinants on the oxidized apolipoprotein-B molecule along with another enzyme immunoassay designed to determine human antibodies to oxidized LDL (anti-oxLDL) directly in serum. Total homocysteine (HCY) was evaluated by means of a fully automated fluorescence polarization immunoassay. Patients with UAP exhibited marked elevations in oxLDL levels as compared to patients with SAP (161.2 +/- 28.4 vs. 119.2 +/- 26.6, p < 0.001) and the control subjects (67 +/- 18.8, p < 0.001). The difference in oxLDL levels between patients with SAP and the control group was also statistically significant. Similarly, patients with UAP showed marked elevations in anti-oxLDL antibodies compared to both patients with SAP (602.2 +/- 62.2 vs. 510.8 +/- 50.3,p < 0.001) and control subjects (368 +/- 79.6, p < 0.001). The difference in anti-oxLDL levels between patients with SAP and the controls was also statistically significant. OxLDL levels were not correlated with age in any of the groups studied. Triglycerides, LDL-cholesterol and total cholesterol were elevated in patients with UAP as opposed to patients with SAP and the control subjects, while HDL levels were elevated in the control subjects when compared to patients with SAP and UAP. Homocysteine levels were elevated in patients suffering from UAP and SAP when compared to healthy subjects. Patients with UAP or SAP did not differ on homocysteine levels. Our findings demonstrate the presence of oxLDL in vivo, its strong association with coronary artery disease as well as with the severity of the clinical presentation.
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Faviou et al. (2005) conducted a cross-sectional in Coronary artery disease (n=273). Circulating oxidized low density lipoprotein (ox-LDL) vs. Healthy controls and stable angina pectoris was evaluated on oxLDL levels (p=<0.001). Plasma levels of oxidized LDL were significantly elevated in patients with unstable angina (161.2) compared to stable angina (119.2) and healthy controls (67.0, p<0.001).
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