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Circulating oxidized LDL is a useful marker for identifying patients with coronary artery disease
P Holvoet1, A Mertens, P Verhamme
1Center for Molecular and Vascular Biology, Catholic University of Leuven, Leuven, Belgium. paul.holvoet@med.kuleuven.ac.be
Insights
Circulating oxidized low-density lipoprotein (LDL) is a sensitive biomarker for identifying coronary artery disease (CAD). Measuring oxidized LDL alongside traditional risk factors improves cardiovascular risk prediction.
Area of Science:
- Cardiovascular Medicine
- Biomarker Discovery
- Clinical Chemistry
Background:
- Coronary artery disease (CAD) poses a significant global health burden.
- Current risk assessment models have limitations in identifying all at-risk individuals.
- Novel biomarkers are needed to enhance cardiovascular risk prediction.
Purpose of the Study:
- To evaluate the diagnostic utility of circulating oxidized low-density lipoprotein (LDL) in identifying patients with CAD.
- To compare the effectiveness of oxidized LDL with the Global Risk Assessment Score (GRAS).
- To determine if oxidized LDL provides additive value to existing risk factors for CAD detection.
Main Methods:
- A study involving 304 subjects: 178 with angiographically confirmed CAD and 126 controls.
- Calculation of the Global Risk Assessment Score (GRAS) based on established risk factors.
- Measurement of circulating oxidized LDL levels using a monoclonal antibody 4E6-based competition ELISA.
- Statistical analysis including logistic regression to assess predictive value.
Main Results:
- CAD patients exhibited significantly higher levels of circulating oxidized LDL and GRAS compared to controls.
- Oxidized LDL demonstrated a sensitivity of 76% for CAD detection, significantly higher than GRAS (20%), with 90% specificity.
- The predictive value of oxidized LDL was found to be additive to GRAS, particularly in identifying high-risk individuals.
Conclusions:
- Circulating oxidized LDL is a sensitive and valuable biomarker for the identification of patients with coronary artery disease.
- Incorporating oxidized LDL measurements into cardiovascular risk assessment may improve the accuracy of identifying individuals with CAD.
- This finding supports the potential of oxidized LDL as a tool for enhanced cardiovascular risk stratification.
Abstract:
Our aim was to determine the usefulness of circulating oxidized low density lipoprotein (LDL) in the identification of patients with coronary artery disease (CAD). A total of 304 subjects were studied: 178 patients with angiographically proven CAD and 126 age-matched subjects without clinical evidence of cardiovascular disease. The Global Risk Assessment Score (GRAS) was calculated on the basis of age, total and high density lipoprotein cholesterol, blood pressure, diabetes mellitus, and smoking. Levels of circulating oxidized LDL were measured in a monoclonal antibody 4E6-based competition ELISA. Compared with control subjects, CAD patients had higher levels of circulating oxidized LDL (P<0.001) and a higher GRAS (P<0.001). The sensitivity for CAD was 76% for circulating oxidized LDL (55% for men and 81% for women) compared with 20% (24% for men and 12% for women) for GRAS, with a specificity of 90%. Logistic regression analysis revealed that the predictive value of oxidized LDL was additive to that of GRAS (P<0.001). Ninety-four percent of the subjects with high (exceeding the 90th percentile of distribution in control subjects) circulating oxidized LDL and high GRAS had CAD (94% of the men and 100% of the women). Thus, circulating oxidized LDL is a sensitive marker of CAD. Addition of oxidized LDL to the established risk factors may improve cardiovascular risk prediction.