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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:877.)
© 2006 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Persistent High Levels of Plasma Oxidized Low-Density Lipoprotein After Acute Myocardial Infarction Predict Stent Restenosis

Takahiko Naruko; Makiko Ueda; Shoichi Ehara; Akira Itoh; Kazuo Haze; Nobuyuki Shirai; Yoshihiro Ikura; Masahiko Ohsawa; Hiroyuki Itabe; Yoshiki Kobayashi; Hiroyuki Yamagishi; Minoru Yoshiyama; Junichi Yoshikawa; Anton E. Becker

From the Department of Cardiology (T.N., A.I., K.H.), Osaka City General Hospital, Japan; the Departments of Pathology (M.U., N.S., Y.I., M.O.) and Internal Medicine and Cardiology (S.E., Y.K., H.Y., M.Y., J.Y.), Osaka City University Graduate School of Medicine, Japan; the Department of Biological Chemistry (H.I.), School of Pharmaceutical Sciences, Showa University, Tokyo, Japan; and Academic Medical Center (A.E.B.), University of Amsterdam, The Netherlands.

Correspondence to Makiko Ueda, MD, Department of Pathology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. E-mail maki{at}med.osaka-cu.ac.jp

Objective— Recently, elevated levels of plasma oxidized low-density lipoprotein (LDL) have been shown to relate to plaque instability in human atherosclerotic lesions. We investigated prospectively patients admitted with acute myocardial infarction (AMI) who underwent primary coronary stenting to evaluate whether the 6-month outcome could be predicted by measuring plasma oxidized LDL (ox-LDL) levels at the time of hospital discharge.

Methods and Results— Plasma ox-LDL levels were measured in 102 patients with AMI undergoing primary coronary stenting using a highly sensitive ELISA method. Measurements were taken on admission and at discharge, and the findings related to the clinical outcome. At 6-month follow-up, angiographic stent restenosis occurred in 25 (25%) of the 102 AMI patients. Plasma ox-LDL levels at discharge were significantly (P=0.0074) higher in the restenosis group than those in the no-restenosis group (1.03±0.65 versus 0.61±0.34 ng/5 µg LDL protein). Multiple regression analysis showed that only plasma ox-LDL levels at discharge were a statistically significant independent predictor for late lumen loss after stenting (ß=0.645; P<0.0001).

Conclusions— This prospective study demonstrates that persistence of an increased level of plasma ox-LDL at discharge is a strong independent predictor of stent restenosis at 6-month follow-up in AMI patients.

We investigated prospectively 102 patients with acute myocardial infarction (AMI) after stenting to evaluate whether plasma oxidized low-density lipoprotein (ox-LDL) levels could predict outcome. This study demonstrates that an increased levels of plasma ox-LDL at discharge is an independent predictor of stent restenosis in AMI patients (ß=0.645;P<0.0001).

Key Words: coronary artery disease • lipoproteins • acute coronary syndromes • stent • restenosis