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The relationship of oxidized lipids to coronary artery stenosis
F A Kummerow1, R M Olinescu, L Fleischer
1The Burnsides Research Laboratory and The Harlan E. Moore Heart Research Foundation, University of Illinois, 1208 W. Pennsylvania Avenue, Urbana, IL 61801, USA.
Insights
Lipid peroxides (LPX), markers of oxidation, accurately identified coronary artery stenosis severity in angina patients, unlike cholesterol levels. Increased PMNL activation and altered antioxidant capacity were also observed.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Clinical Diagnostics
Background:
- Coronary artery stenosis is a primary cause of angina.
- Current diagnostic markers like cholesterol may not fully reflect stenosis severity.
- Oxidative stress markers warrant investigation for their diagnostic utility.
Purpose of the Study:
- To evaluate the correlation between plasma lipid peroxides (LPX) and coronary artery stenosis severity.
- To compare the diagnostic value of LPX with plasma cholesterol concentration in angina patients.
- To assess other plasma biomarkers, including polymorphonuclear leukocyte (PMNL) activation, total antioxidant capacity (TAOC), fibrinogen (FB), and ceruloplasmin (CP), in relation to stenosis.
Main Methods:
- Cardiac catheterization was performed on 1200 angina patients to determine coronary artery stenosis (0%, 10-69%, 70-100%).
- Plasma samples were analyzed for cholesterol, LPX, TAOC, FB, CP, and PMNL activation.
- Data were compared between stenosis groups and with non-smoking, angina-free controls.
Main Results:
- LPX concentrations significantly differed across all stenosis severity groups (P<0.001) and were elevated in patients compared to controls (P<0.001).
- Plasma cholesterol levels did not show significant differences related to stenosis severity.
- Catheterized patients exhibited increased PMNL activation (P<0.01), elevated FB and CP (P<0.01), and decreased TAOC compared to controls.
Conclusions:
- Plasma LPX concentration is a more reliable indicator of coronary artery stenosis severity than plasma cholesterol.
- Elevated oxidation products and altered inflammatory markers are associated with coronary artery stenosis in angina patients.
- LPX measurement offers a promising diagnostic approach for assessing coronary artery disease severity.
Abstract:
A total of 1200 patients with angina were cardiac catheterized establishing that 63% had 70-100% stenosis, 12% had 10-69% stenosis of one or more of their coronary arteries and 25% had microvascular angina listed as 0% stenosis. Prior to catheterization 10 ml of blood was drawn and the plasma subjected to analysis for the concentration of cholesterol, lipid peroxides (LPX), total antioxidant capacity (TAOC), fibrinogen (FB), ceruloplasmin (CP) and activation of polymorphonuclear leukocytes (PMNLs). Comparisons were made to non-smoking controls without angina. Significant differences in LPX were found between the patients with 0 and 10-69% stenosis (P<0.001), with 10-69 and 70-100% stenosis (P<0.001), and with 0 and 70-100% stenosis (P<0.001). Under 70 years of age there was a significant difference in LPX between patients with all levels of stenosis and age and sex matched controls (P<0.001). Differences in the mean plasma cholesterol concentration for different levels in the degree of stenosis were not significant, indicating that LPX provided consistent data on the severity of stenosis while the plasma cholesterol concentration did not. Compared with controls an increase in activation of PMNLs (P<0.01), an increase in concentration of both FB and CP (P<0.01) and a decrease in total antioxidant capacity were noted in the plasma of catheterized patients. In summary the concentration of oxidation products rather than the concentration of cholesterol in the plasma identified stenosis in cardiac catheterized patients.