© 2000 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Oxidized Low Density Lipoprotein Is a Prognostic Marker of Transplant-Associated Coronary Artery Disease
From the Center for Molecular and Vascular Biology (P.H., D.C.) and the Department of Cardiology (J.V.C., J.V.), University of Leuven, Leuven, Belgium.
Correspondence to Dr P. Holvoet, Center for Molecular and Vascular Biology, Herestraat 49, B-3000 Leuven, Belgium. E-mail paul.holvoet{at}med.kuleuven.ac.be
Abstract—Retrospective studies
identified oxidized low density lipoprotein (LDL) in the blood as a
diagnostic marker of coronary artery disease (CAD).
This prospective study sought to determine the prognostic value of
oxidized LDL for CAD in cardiac transplant patients. Oxidized LDL was
measured in 99 cardiac transplant patients with normal coronary
angiograms at baseline and was measured again after a median follow-up
of 2 years at the time of a second angiogram. Twenty-one patients
developed angiographically detectable cardiac transplant vasculopathy
(cases), and 78 individuals did not (controls). Cases had significantly
higher baseline plasma levels of oxidized LDL than did controls:
1.18±0.70 versus 0.57±0.20 mg/dL (mean±SD,
P<0.0001). The increase of oxidized LDL at the end of
the follow-up was significantly higher in cases than in controls:
0.75±0.73 mg/dL versus 0.14±0.27 mg/dL (P<0.0001).
Baseline levels of oxidized LDL predicted cardiac transplant
vasculopathy (
2=16, P<0.0001)
independent of pretransplant ischemic
cardiomyopathy, time after transplantation, age,
and serum levels of LDL and high density lipoprotein
cholesterol. The development of transplant CAD was
associated with a further increase of plasma levels of oxidized LDL
(2=14, P=0.0002). Oxidized LDL is a
prognostic marker of transplant CAD.
Key Words: lipoproteins • transplantation • coronary artery disease • prognosis
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