Abstract
Background: It has been shown that elevated oxidized low-density lipoprotein (ox-LDL) levels are associated with plaque vulnerability. The aim of this study was to investigate whether circulating ox-LDL levels are correlated with coronary lesion complexity assessed by optical coherence tomography (OCT) in patients with acute coronary syndrome (ACS). Methods and Results: OCT was used to determine plaque morphology in 80 patients with ACS. Blood samples were collected before coronary angiography and circulating levels of malondialdehyde (MDA)-modified LDL, one of ox-LDL, were measured by using enzyme-linked immunosorbent assay. Patients were divided into a high MDA-modified LDL group (high MDA, ≥155 U/L) and low MDA-modified LDL group (low MDA, < 155 U/L) according to median MDA-modified LDL levels. Plaque ruptures and thin cap fibroatheromas (TCFAs) were more frequently observed in high MDA patients compared to low MDA patients (87% vs. 56%, P<0.01; 65% vs. 43%, P<0.05, respectively). The frequency of thrombi was not different between two groups. The MDA-modified LDL levels in patients with complicated lesions (defined as lesions with plaque rupture or rupture with thrombi) were significantly higher compared to non-complicated lesion (P<0.05). A multivariate logistic regression model revealed that the presence of complicated lesion correlated with MDA-modified LDL levels ( P =0.03; odds ratio, 3.13; 95% CI, 1.09 to 8.93). Conclusion: Circulating MDA-modified LDL levels were associated with coronary plaque complexity assessed by OCT. MDA-modified LDL might be a useful biomarker for plaque vulnerability in ACS patients.
Published Version
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