Abstract
ObjectivesOxidized low-density lipoproteins (oxLDL) and oxidized low-density lipoprotein autoantibodies (OLAB) have been detected in human plasma and atherosclerotic lesions. OLAB appear to play a role in the clearance of oxLDL from circulation. Higher levels of OLAB appear to be associated with a reduced risk of a wide range of cardiovascular diseases. We investigated the prognostic value of plasma oxLDL and OLAB in patients undergoing primary coronary balloon angioplasty for acute ST-elevation myocardial infarction (STEMI).MethodsPlasma oxLDL and OLAB concentrations were measured in 56 patients with acute STEMI before primary angioplasty, and then 3 days, 7 days and 1 month after the acute event. Follow-up angiography was repeated 6 months later to detect the presence of restensosis (defined as >50% luminal diameter stenosis). The thrombolysis in myocardial infarction (TIMI) risk score was calculated to determine the relationship between OLAB/oxLDL ratio and TIMI risk scores.ResultsOf the 56 patients, 18 (31%) had angiographic evidence of restenosis. Plasma OLAB concentrations were significantly lower in the restenosis group before angioplasty (181±114 vs. 335±257 U/L, p = 0.003), and at day 3 (155±92 vs. 277±185 U/L, p<0.001) and day 7 (177±110 vs. 352±279 U/L, p<0.001) after the acute event. There was no difference in oxLDL concentration between the two groups. The ratio of OLAB/oxLDL positively correlated with TIMI risk scores before angioplasty (p for trend analysis, p = 0.004), at day 3 (p = 0.008) and day 7 (p<0.001) after STEMI.SignificanceA relative deficit of OLAB, and hence likely impaired clearance of oxLDL, is associated with the risk of arterial restenosis after primary angioplasty for acute STEMI.
Highlights
The main cause of acute myocardial infarction (AMI) is the rupture of vulnerable plaques and the subsequent formation of thrombi [1]
The ratio of oxidized low-density lipoprotein autoantibodies (OLAB)/oxidized low-density lipoproteins (oxLDL) positively correlated with thrombolysis in myocardial infarction (TIMI) risk scores before angioplasty (p for trend analysis, p = 0.004), at day 3 (p = 0.008) and day 7 (p,0.001) after ST-elevation myocardial infarction (STEMI)
Pawlak et al recently found that the ratio of serum OLAB to oxLDL influenced the extent of carotid atherosclerosis and risk of cardiovascular complications in dialyzed patients with renal impairment [8], leading the authors to hypothesized that the ratio reflects the balance between the modification of LDL induced by oxidative stress and the rate of clearance of oxLDL from the circulation
Summary
The main cause of acute myocardial infarction (AMI) is the rupture of vulnerable plaques and the subsequent formation of thrombi [1]. As oxidized low-density lipoprotein autoantibodies (OLAB) play a role in the clearance of oxLDL from the circulation, it has been hypothesized that they may protect against the risk of atherosclerosis [5]. Subjects with a high OLAB to oxLDL ratio had the lowest carotid artery intimal thickness (CCA-IMT) and lowest LDL levels. These findings suggest that both a high plasma oxLDL and low plasma OLAB contribute to the development of atherosclerosis [7]. Pawlak et al recently found that the ratio of serum OLAB to oxLDL influenced the extent of carotid atherosclerosis and risk of cardiovascular complications in dialyzed patients with renal impairment [8], leading the authors to hypothesized that the ratio reflects the balance between the modification of LDL induced by oxidative stress and the rate of clearance of oxLDL from the circulation.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
