Abstract 13801: Circulating Malondialdehyde-Modified Low-Density Lipoprotein Levels Correlate with Thin Cap Fibroatheroma Determined by Optical Coherence Tomography in Coronary Artery Disease
Background: It has been shown that elevated oxidized low-density lipoprotein (LDL) play a critical role in the transition from stable to vulnerable plaque. The purpose of this study was to evaluate the relationship between coronary plaque instability and circulating biomarkers including malondialdehyde (MDA)-modified LDL and high sensitive C-reactive protein (hs-CRP) in clinical setting.
Methods and Results: Optical coherence tomography was used to determine plaque instability in 80 patients with acute coronary syndrome (ACS; n=45), and stable angina (SAP; n=35). Blood samples were collected before coronary angiography and circulating MDA-modified LDL and hs-CRP were measured by using enzyme-linked immunosorbent assay. Thin cap fibroatheromas (TCFA; defined as lipid-rich with plaque cap thickness less than 65 μm) were detected more frequently in ACS than in SAP (93% vs. 28%, p<0.01). Both MDA-modified LDL and hs-CRP levels were significantly higher in patients with TCFA compared with patients without TCFA (164±55 U/L vs. 87±25 U/L; p<0.01, and 2.6±2.4 mg/dL vs. 0.6±0.4 mg/dL; p<0.01, respectively). MDA-modified LDL levels were associated with TCFA in multivariable logistic regression analysis. In analysis with receiver operator characteristic curves for MDA-modified LDL and hs-CRP, the area under the curves were 0.96 and 0.80, respectively. Given a cut-off value of 110 U/L, MDA-modified LDL can discriminate TCFA from non-TCFA with 91% and 80% of sensitivity and specificity, respectively.
Conclusions: Circulating MDA-modified LDL might be a useful marker for plaque instability in coronary atherosclerotic lesions.
- © 2010 by American Heart Association, Inc.