Elevated levels of oxidized low density lipoprotein show a positive relationship with the severity of acute coronary syndromes

被引:630
|
作者
Ehara, S
Ueda, M
Naruko, T
Haze, K
Itoh, A
Otsuka, M
Komatsu, R
Matsuo, T
Itabe, H
Takano, T
Tsukamoto, Y
Yoshiyama, M
Takeuchi, K
Yoshikawa, J
Becker, AE
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Cardiovasc Pathol, NL-1105 AZ Amsterdam, Netherlands
[2] Teikyo Univ, Fac Pharmaceut Sci, Dept Microbiol & Mol Pathol, Kanagawa, Japan
[3] Osaka City Univ, Sch Med, Dept Pathol, Abeno Ku, Osaka 5458585, Japan
[4] Osaka City Univ, Sch Med, Dept Internal Med 1, Osaka 5458585, Japan
[5] Osaka City Gen Hosp, Dept Cardiol, Osaka, Japan
关键词
atherosclerosis; coronary disease; myocardial infarction; angina;
D O I
10.1161/01.cir.103.15.1955
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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<plus/minus>1.42 ng/5 mug LDL protein; UAP, 1.19 +/-0.74 ng/5 mug LDL protein; SAP, 0.89 +/-0.48 ng/5 mug LDL protein; control, 0.58 +/-0.23 ng/5 mug 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.
引用
收藏
页码:1955 / 1960
页数:6
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