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(Circulation. 1998;98:1487-1494.)
© 1998 American Heart Association, Inc.

Clinical Investigation and Reports

Oxidized LDL and Malondialdehyde-Modified LDL in Patients With Acute Coronary Syndromes and Stable Coronary Artery Disease

Paul Holvoet, PhD; Johan Vanhaecke, MD, PhD; Stefaan Janssens, MD, PhD; Frans Van de Werf, MD, PhD; ; Désiré Collen, MD, PhD

From the Center for Molecular and Vascular Biology (P.H., D.C.) and Department of Cardiology (J.V., S.J., F.V.d.W.), University of Leuven, Belgium.

Correspondence to P. Holvoet, PhD, Center for Molecular and Vascular Biology, University of Leuven, Campus Gasthuisberg, O&N, Herestraat 49, B-3000 Leuven, Belgium. E-mail paul.holvoet{at}med.kuleuven.ac.be

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 (r²=0.57 and r²=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 (r²=0.65; P=0.0001) and were associated with increased levels of troponin I and C-reactive protein (r²=0.39 and r²=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 (r²=0.089 and r²=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.

Key Words: lipoproteins • coronary disease • angina • diagnosis • plaque

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