Antibodies to malondialdehyde oxidized low-density lipoproteins predict long term cardiovascular mortality in high risk patients
Maiolino G, Pedon L, Cesari M, Frigo AC, Barisa M, Rossitto G, Seccia TM, Zanchetta M, Rossi GP.
Antibodies to oxidizedlow-densitylipoproteins (oxLDLAbs) are detectable in the serum of patients with and without atherosclerosis, but it is unclear if they play a pathogenic or a protective role in atherogenesis or if they are simply a marker of atherosclerosis. Therefore, in a prospective cohort study we investigated if oxLDLAbs titer predicts cardiovascular (CV) events in high–risk coronary artery disease patients.
METHODS AND RESULTS:
The titer of IgG antibodies to malondialdehyde modified oxidizedlow-densitylipoproteins was measured in 748 randomly selected patients of the GENICA study who underwent coronary angiography and assessment of incident CV events at follow-up. Patients were classified by oxLDLAbs into a low and a high titer group, corresponding to the first three and the last quartile, respectively. Cardiovascular event-free survival was compared between oxLDLAbs groups by Kaplan-Meier and multivariate technique including propensity score matching analysis. During long–term follow-up (median 7.2years) CV deaths were observed in 65 patients (11.6%), more commonly in the high than in the low oxLDLAbs group (patients free from CV death 83.1% vs. 89% respectively, p=0.025). The incidence of CV events was also higher in the former than in latter (event-free survival 69.2% vs. 77.7% respectively, p=0.030).
An oxLDLAbs titer above the 75th percentile is a marker of LDL oxidation which predicts a worse CV prognosis at longterm follow-up in high–risk Caucasian patients referred for coronary angiography