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Clinical Trial
. 2013 Oct 3;8(10):e74726.
doi: 10.1371/journal.pone.0074726. eCollection 2013.

Using oxidized low-density lipoprotein autoantibodies to predict restenosis after balloon angioplasty in patients with acute myocardial infarction

Ching-Hui Huang  1 , Chia-Chu Chang, Ching-Shan Huang, Chen-Ling Kuo, Ching-Pei Chen, Chien-Hsun Hsia, Yung-Ming Chang, Hung-Te Chen, Chih-Chung Feng, Lee-Shin Lin, Po-Ta Yang, Chen-Dao Tsai, Chih-Sheng Lin, Chin-San Liu
Affiliations
Clinical Trial

Using oxidized low-density lipoprotein autoantibodies to predict restenosis after balloon angioplasty in patients with acute myocardial infarction

Ching-Hui Huang et al. PLoS One. .

Abstract

Objectives: Oxidized low-density lipoproteins (oxLDL) and oxidized low-density lipoprotein autoantibodies (OLAB) have been detected in human plasma and atherosclerotic lesions. OLAB appear to play a role in the clearance of oxLDL from circulation. Higher levels of OLAB appear to be associated with a reduced risk of a wide range of cardiovascular diseases. We investigated the prognostic value of plasma oxLDL and OLAB in patients undergoing primary coronary balloon angioplasty for acute ST-elevation myocardial infarction (STEMI).

Methods: Plasma oxLDL and OLAB concentrations were measured in 56 patients with acute STEMI before primary angioplasty, and then 3 days, 7 days and 1 month after the acute event. Follow-up angiography was repeated 6 months later to detect the presence of restensosis (defined as >50% luminal diameter stenosis). The thrombolysis in myocardial infarction (TIMI) risk score was calculated to determine the relationship between OLAB/oxLDL ratio and TIMI risk scores.

Results: Of the 56 patients, 18 (31%) had angiographic evidence of restenosis. Plasma OLAB concentrations were significantly lower in the restenosis group before angioplasty (181±114 vs. 335±257 U/L, p = 0.003), and at day 3 (155±92 vs. 277±185 U/L, p<0.001) and day 7 (177±110 vs. 352±279 U/L, p<0.001) after the acute event. There was no difference in oxLDL concentration between the two groups. The ratio of OLAB/oxLDL positively correlated with TIMI risk scores before angioplasty (p for trend analysis, p = 0.004), at day 3 (p = 0.008) and day 7 (p<0.001) after STEMI.

Significance: A relative deficit of OLAB, and hence likely impaired clearance of oxLDL, is associated with the risk of arterial restenosis after primary angioplasty for acute STEMI.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Changes in oxidized low-density lipoprotein (oxLDL) levels in patients in the Restenosis and Non-Restenosis groups.
The patients received follow-up angiography 6 months after PCI to detect the presence of restensosis (n = 18) or non-restenosis (n = 38). Restenosis is defined as >50% luminal diameter stenosis.
Figure 2
Figure 2. Changes in oxidized low-density lipoprotein autoantibodies (OLAB) levels in patients in the Restenosis (n = 18) and Non-Restenosis (n = 38) groups.
** p<0.01 and *** p<0.001, Mann-Whitney U test.
Figure 3
Figure 3. Prognostic value of serial oxidized low-density lipoprotein autoantibodies (OLAB) for restenosis in STEMI patients after primary balloon angioplasty.
The areas under the curves (AUC) for OLAB as a predictor of restenosis were 0.697 before PCI (95% CI, 0.557–0.838; p = 0.018), 0.708 on day 3 (95% CI, 0.570–0.845; p = 0.013), and 0.712 on day 7 (95% CI, 0.576–0.848; p = 0.011).
See this image and copyright information in PMC

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