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Oxidized Phospholipids Predict the Presence and Progression of Carotid and Femoral Atherosclerosis and Symptomatic Cardiovascular Disease

Five-Year Prospective Results From the Bruneck Study

Sotirios Tsimikas, MD^_*,_*, Stefan Kiechl, MD, Johann Willeit, MD, Manuel Mayr, MD^,, Elizabeth R. Miller, BS^_*, Florian Kronenberg, MD^¶, Qingbo Xu, MD^,, Claes Bergmark, MD^||, Siegfried Weger, MD^#, Friedrich Oberhollenzer, MD^# and Joseph L. Witztum, MD^_*

^_* Department of Medicine, University of California San Diego, La Jolla, California
Department of Cardiological Sciences, St. George's Hospital Medical School, London, United Kingdom
Institute for Biomedical Aging Research, Austrian Academy of Sciences, Innsbruck, Austria
Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
^|| Department of Vascular Surgery, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
^¶ Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Innsbruck Medical University, Innsbruck, Austria
^# Department of Internal Medicine, Bruneck Hospital, Bruneck, Italy

View larger version (17K): [in a new window]   Figure 1 Plot of oxidized phospholipids (OxPL) values (in relative light units [RLU]) against OxPL/apolipoprotein B-100 particles (apoB) (ratio) values indicating a very high correlation of r = 0.995, p < 0.001 (n = 1,436).

View larger version (8K): [in a new window]   Figure 2 Comparative presentation of distributions of oxidized phospholipids (OxPL)/apolipoprotein B-100 particles (apoB) (A) and lipoprotein (a) (B) and plot of OxPL/apoB versus lipoprotein (a) (C) indicating a very high correlation (data from 1995; r = 0.87, p < 0.001, n = 765).

View larger version (13K): [in a new window]   Figure 3 Plot of oxidized phospholipids (OxPL)/apolipoprotein B-100 particles (apoB) values in 1995 against OxPL/apoB values in 2000 indicating considerable consistency over time (r = 0.78, p < 0.001, n = 671).

View larger version (50K): [in a new window]   Figure 4 Three-dimensional plot of oxidized phospholipids (OxPL)/apolipoprotein B-100 particle (apoB) levels according to lipoprotein (a) [Lp(a)] mass and apolipoprotein (a) [Apo(a)] phenotypes expressed as the number of kringle IV-type 2 repeats. The OxPL/apoB levels presented are geometric means (taken as the antilog of the mean of loge-transformed OxPL/apoB values).

View larger version (43K): [in a new window]   Figure 5 Multivariate analysis showing the association of oxidized phospholipids (OxPL)/apolipoprotein B-100 particle (apoB) tertile groups with presence and progression of carotid and femoral artery atherosclerosis and with cardiovascular disease. For adjustment see Table 2. *p < 0.05 for the comparison between the first tertile group (reference category) and the third tertile group. The p values presented in the figures are the overall p values for the three tertiles (test for trend).