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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:218.)
© 2006 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Low-Density Lipoprotein Cholesterol Determines Oxidative Stress and Endothelial Dysfunction in Saphenous Veins From Patients With Coronary Artery Disease

Sammy Al-Benna; Carlene A. Hamilton; John D. McClure; Paul N. Rogers; Geoffrey A. Berg; Ian Ford; Christian Delles; Anna F. Dominiczak

From the BHF Glasgow Cardiovascular Research Centre, Division of Cardiovascular and Medical Sciences (S.A.-B., C.A.H., J.D.M., C.D., A.F.D.), and Robertson Centre for Biostatistics (I.F.), University of Glasgow; the Department of Vascular Surgery (P.N.R.), Gartnavel General Hospital; and Department of Cardiothoracic Surgery (G.A.B.), Western Infirmary, Glasgow, United Kingdom.

Correspondence to Anna F. Dominiczak, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Division of Cardiovascular and Medical Sciences, Glasgow G11 6NT, United Kingdom. E-mail ad7e{at}clinmed.gla.ac.uk

Objective— There is evidence for a relationship between endothelial dysfunction and cardiovascular disease, but a causative role for oxidative stress remains to be determined.

Methods and Results— We studied 188 patients with severe coronary artery disease (CAD), of whom 51 were age and sex matched with 51 healthy controls undergoing varicose vein surgery. Relaxation of saphenous vein to calcium ionophore, apocynin, and allopurinol was studied together with the markers of oxidative stress, total antioxidant capacity and reduced/oxidized glutathione ratio. Vascular superoxide levels were measured using lucigenin chemiluminescence and hydroethidine. Relaxation to calcium ionophore was decreased in CAD compared with control patients (maximum relaxation 26±2% versus 60±1%; P<0.001). Total superoxide production was increased (0.89±0.09 versus 0.56±0.06 nmol/mg per min; P=0.008), whereas superoxide inhibition with apocynin or allopurinol had a greater effect on vasorelaxation in CAD patients. Low-density lipoprotein (LDL) cholesterol predicted relaxation to calcium ionophore (P<0.001) and oxidative stress markers (P<0.001) in CAD patients.

Conclusions— Endothelial dysfunction is associated with raised levels of superoxide and biomarkers of oxidative stress in saphenous veins from CAD patients. LDL cholesterol is a major determinant of endothelial dysfunction and oxidative stress in these patients. These results support intensive LDL cholesterol-lowering therapy as suggested by recent clinical trials.

We examined the role of oxidative stress in the relationship between endothelial dysfunction of saphenous veins and cardiovascular disease. Low-density lipoprotein cholesterol was the major determinant of endothelial dysfunction and oxidative stress in patients with coronary artery disease. These results support intensive low-density lipoprotein cholesterol-lowering therapy as suggested by recent clinical trials.

Key Words: endothelium • nitric oxide • free radicals • lipids • atherosclerosis

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