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(Circulation. 2001;103:1955.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Elevated Levels of Oxidized Low Density Lipoprotein Show a Positive Relationship With the Severity of Acute Coronary Syndromes
From the Department of Cardiology (S.E., T.N., K.H., A.I., M.O.), Osaka City General Hospital; the Department of Pathology (M.U., R.K., T.M.) and First Department of Internal Medicine (M.Y., K.T., J.Y.), Osaka City University Medical School, Osaka; the Department of Microbiology and Molecular Pathology (H.I., T.T.), Faculty of Pharmaceutical Sciences, Teikyo University, Kanagawa, Japan; and the Department of Cardiovascular Pathology (Y.T., A.E.B.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Correspondence to Makiko Ueda, MD, Department of Pathology, Osaka City University Medical School, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. E-mail maki{at}med.osaka-cu.ac.jp
Background—There is accumulating data that acute coronary syndromes relate to recent onset activation of inflammation affecting atherosclerotic plaques. Increased blood levels of oxidized low density lipoprotein (ox-LDL) could play a role in these circumstances.
Methods and Results—Ox-LDL levels were measured in 135 patients with acute myocardial infarction (AMI; n=45), unstable angina pectoris (UAP; n=45), and stable angina pectoris (SAP; n=45) and in 46 control subjects using a sandwich ELISA method. In addition, 33 atherectomy specimens obtained from a different cohort of patients with SAP (n=10) and UAP (n=23) were studied immunohistochemically for ox-LDL. In AMI patients, ox-LDL levels were significantly higher than in patients with UAP (P<0.0005) or SAP (P<0.0001) or in controls (P<0.0001) (AMI, 1.95±1.42 ng/5 µg LDL protein; UAP, 1.19±0.74 ng/5 µg LDL protein; SAP, 0.89±0.48 ng/5 µg LDL protein; control, 0.58±0.23 ng/5 µg LDL protein). Serum levels of total, HDL, and LDL cholesterol did not differ among these patient groups. In the atherectomy specimens, the surface area containing ox-LDL–positive macrophages was significantly higher in patients with UAP than in those with SAP (P<0.0001).
Conclusions—This study demonstrates that ox-LDL levels show a significant positive correlation with the severity of acute coronary syndromes and that the more severe lesions also contain a significantly higher percentage of ox-LDL–positive macrophages. These observations suggest that increased levels of ox-LDL relate to plaque instability in human coronary atherosclerotic lesions.
Key Words: atherosclerosis • coronary disease • myocardial infarction • angina
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