Oxidized LDL and malondialdehyde-modified LDL in patients with acute coronary syndromes and stable coronary artery disease
Oxidized LDL and malondialdehyde-modified LDL in patients with acute coronary syndromes and stable coronary artery disease
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DOI：
10.1161/01.cir.98.15.1487
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发表时间：
1998-10-13
期刊：
影响因子：
37.8
通讯作者：
Collen, D
中科院分区：
文献类型：
--
作者：
Holvoet, P;Vanhaecke, J;Collen, D
背景——人们怀疑 LDL 氧化修饰与冠状动脉疾病 (CAD) 之间存在关联，但尚未确定。因此，我们研究了氧化 LDL 和丙二醛 (MDA) 修饰 LDL 的血浆水平与急性冠脉综合征和稳定型 CAD 之间的关联。 方法和结果 - 研究人群包括 63 名急性冠脉综合征患者（45 名急性心肌梗死，18 名不稳定型心绞痛），35 名非移植患者 血管造影证实稳定型心绞痛、28 名患有移植后 CAD 的心脏移植患者、79 名无 CAD 的心脏移植患者以及 65 名对照受试者。校正年龄、性别以及 LDL 和 HDL 胆固醇后，CAD 患者血浆氧化 LDL 和 MDA 修饰 LDL 水平显着高于非 CAD 患者（分别为 r(2) = 0.57 和 r(2) = 0.26；均 P = 0.0001）。急性冠状动脉综合征患者的 MDA 修饰 LDL 血浆水平显着高于稳定 CAD 患者（r(2) = 0.65；P = 0.0001），并且与肌钙蛋白 I 和 C 反应蛋白水平升高相关（分别为 r(2) = 0.39 和 r(2) = 0.34；均 P = 0.0001）。不相关 肌钙蛋白 I 和 C 反应蛋白水平升高（分别为 r(2) = 0.089 和 r(2) = 0.063）。结论 - 血浆氧化 LDL 水平升高与 CAD 相关。 MDA 修饰的 LDL 血浆水平升高表明斑块不稳定，可能有助于识别急性冠状动脉综合征患者。
Background - The association between oxidative modifications of LDL and coronary artery disease (CAD) is suspected but not established. Therefore, the association between plasma levels of oxidized LDL and malondialdehyde (MDA)-modified LDL and acute coronary syndromes and stable CAD was investigated.Methods and Results - The study population contained 63 patients with acute coronary syndromes (45 with acute myocardial infarction and 18 with unstable angina pectoris), 35 nontransplanted patients with angiographically confirmed stable angina, 28 heart transplant patients with posttransplant CAD, 79 heart transplant patients without CAD, and 65 control subjects. After correction for age, sex, and LDL and HDL cholesterol, plasma levels of oxidized LDL and MDA-modified LDL were significantly higher in patients with CAD than in individuals without CAD (r(2) = 0.57 and r(2) = 0.26, respectively; both P = 0.0001). Plasma levels of MDA-modified LDL were significantly higher in patients with acute coronary syndromes than in individuals with stable CAD (r(2) = 0.65; P = 0.0001) and were associated with increased levels of troponin I and C-reactive protein (r(2) = 0.39 and r(2) = 0.34, respectively; both P = 0.0001), Plasma levels of oxidized LDL were not associated with increased levels of troponin I and C-reactive protein (r(2) = 0.089 and r(2) = 0.063, respectively).Conclusions - Elevated plasma levels of oxidized LDL are associated with CAD. Elevated plasma levels of MDA-modified LDL suggest plaque instability and may be useful for the identification of patients with acute coronary syndromes.