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CLINICAL STUDY: CORONARY ARTERY DISEASE

Clinical significance of antibody against oxidized low density lipoprotein in patients with atherosclerotic coronary artery disease

^a Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya, Saitama, Japan

Manuscript received July 10, 2000; revised manuscript received October 24, 2000, accepted November 29, 2000.

Reprint requests and correspondence: Dr. Teruo Inoue, Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, 2-1-50 Minamikoshigaya, Koshigaya City, Saitama 343-8555, Japan
inouet{at}dokkyomed.ac.jp

OBJECTIVES

This study was designed to establish the clinical significance of antibodies against oxidized low density lipoprotein (anti-Ox-LDL) titer in atherosclerotic coronary artery disease (CAD).

BACKGROUND

Oxidative modification of LDL, which plays a key role in the development of atherosclerosis, induces immunogenic epitopes in the LDL molecule, and the presence of anti-Ox-LDL has been demonstrated in human sera.

METHODS

Anti-Ox-LDL titer was measured by enzyme-linked immunosorbent assay in 108 patients who had angiographically verified CAD, and 31 patients who had chest pain but no significant CAD, as controls.

RESULTS

The anti-Ox-LDL titer was higher (p < 0.01) in patients with multivessel CAD (19.4 ± 10.1 AcU/ml, n = 68) than in the controls (9.8 ± 4.1). However, no significant difference was shown between the single-vessel CAD group (15.1 ± 6.4, n = 40) and the controls, or between the multivessel CAD group and the single-vessel CAD group. The titer was higher in patients with unstable angina (21.5 ± 11.8 AcU/ml, n = 20, p < 0.01), or in patients with acute myocardial infarction (23.1 ± 12.0, n = 20, p < 0.01) than in patients with stable-effort angina or old myocardial infarction (12.2 ± 8.6, n = 68). Multiple logistic regression analysis indicated that the anti-Ox-LDL titer most powerfully discriminated CAD patients from controls (odds ratio [OR]: 1.20, 95% confidence interval [CI]: 1.07–1.33, p = 0.0006) and acute coronary syndrome from chronic CAD (OR: 1.09, 95% CI: 1.04–1.14, p = 0.0008).

CONCLUSIONS

Serum anti-Ox-LDL titer not only can predict a presence of atherosclerotic CAD but also may be a marker of plaque instability. Low density lipoprotein oxidation may play an important role in the development of plaque instability.

Abbreviations and Acronyms   AMI = acute myocardial infarction   ANOVA = one-way analysis of variance   anti-Ox-LDL = antibodies against oxidized low density lipoprotein   apo = apolipoprotein   CAD = coronary artery disease   CI = confidence interval   ELISA = enzyme-linked immunosorbent assay   HDL = high density lipoprotein   LDL = low density lipoprotein   Lp(a) = lipoprotein (a)   MDA = malonic dialdehyde   OMI = old myocardial infarction   OR = odds ratio   p-NPP = p-nitrophenyl phosphate

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