Association of Arterial Stiffness with Oxidative Stress in Patients with Left Main Coronary Artery Disease: A Pilot Study from Pathumthani, Thailand

Background: Left main coronary artery disease (LMCAD) can substantially compromise myocardial blood supply. Plasma malondialdehyde (MDA), a marker of lipid peroxidation, is associated with coronary atherosclerosis and arterial stiffness, the latter of which is measured by the cardio-ankle vascular index (CAVI). This study aimed to evaluate the relationships among lipid profiles, plasma MDA levels, and CAVI in patients with LMCAD. Methods: A total of 186 patients presenting with new-onset chest pain underwent coronary angiography at Thammasat University Hospital, Thailand between June 2021 and August 2022; Of these, 23 patients were diagnosed with LMCAD, while 25 participants without significant coronary artery occlusion served as the non-coronary artery disease (non-CAD) group. Blood samples were collected after an 8-hour fast for routine laboratory testing and measurement of plasma MDA levels. Arterial stiffness was assessed using CAVI. Between-group comparisons were performed using the t-test, and associations between variables were evaluated using Pearson correlation analysis. Results: The 48 participants had a mean age of 67.2±9.7 years, and 56% were male. Patients with LMCAD exhibited significantly higher plasma MDA levels (p<0.001) and CAVI values (p=0.007) than non-CAD patients. Triglyceride levels showed a significant positive correlation with plasma MDA (r=0.388, p=0.006), whereas HDL-cholesterol levels were negatively associated with both plasma MDA (r=0.317, p=0.028) and CAVI (r =-0.297, p=0.041). Although plasma MDA was not significantly correlated with CAVI (r=0.250, p=0.086). Conclusions: Higher plasma MDA and CAVI were found in LMCAD patients. Triglyceride and HDL cholesterol levels associated with plasma MDA. Despite a non-significant correlation between MDA and CAVI, further investigation with a larger sample size is warranted.