Serum malondialdehyde-modified low-density lipoprotein levels on admission predict prognosis in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Naofumi Amioka, Toru Miyoshi, Hiroaki Otsuka, Daisuke Yamada, Atsushi Takaishi, Masayuki Ueeda, Satoshi Hirohata, Hiroshi Itoh

Research output: Contribution to journalArticle

Abstract

Background: Malondialdehyde-modified low-density lipoprotein (MDA-LDL) is a predictive marker of cardiovascular events in patients with stable angina pectoris. However, little is known about this marker in patients with acute coronary syndrome (ACS). We investigated the prognostic relevance of MDA-LDL to cardiovascular outcomes in patients with ACS. Methods: A total of 370 consecutive patients with ACS who underwent primary percutaneous coronary intervention (PCI) were enrolled from October 2009 to September 2014 at Mitoyo General Hospital. Serum MDA-LDL levels were measured at admission. The patients were divided into three tertile groups according to serum MDA-LDL levels. The primary outcomes were cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, revascularization, and heart failure requiring hospital admission. Results: MDA-LDL levels in patients with acute myocardial infarction were significantly greater than those in patients with unstable angina pectoris (mean ± standard deviation: 133 ± 48 U/L vs. 157 ± 69 U/L, p = 0.001). During follow-up [472 (195–920) days], 82 (22%) events occurred. Kaplan–Meier analysis showed that patients in the highest MDA-LDL tertile had the worst prognosis (log-rank, p < 0.001). Cox regression analysis showed that serum MDA-LDL levels were an independent predictor of cardiovascular events after PCI in patients with ACS, even after adjustment for age, sex, body mass index, conventional cardiovascular risk factors, other lipid biomarkers, statin use on admission, cardiac biomarkers, and presence or absence of multivessel disease (hazard ratio: 1.80 per 1 standard deviation U/L increase, 95% confidence interval: 1.07–3.16, p = 0.027). Conclusion: Serum MDA-LDL levels on admission are a significant prognostic marker in patients with ACS who undergo successful PCI.

Original languageEnglish
JournalJournal of Cardiology
DOIs
Publication statusPublished - Jan 1 2019

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Percutaneous Coronary Intervention
Acute Coronary Syndrome
Malondialdehyde
LDL Lipoproteins
Serum
Biomarkers
Myocardial Infarction
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Stable Angina
Unstable Angina
General Hospitals
Body Mass Index
Heart Failure
Stroke
Regression Analysis
Confidence Intervals
Lipids

Keywords

  • Coronary artery disease
  • Oxidized low-density lipoprotein
  • Percutaneous coronary intervention
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{3d0886e139954cb0acb369fcee0530cd,
title = "Serum malondialdehyde-modified low-density lipoprotein levels on admission predict prognosis in patients with acute coronary syndrome undergoing percutaneous coronary intervention",
abstract = "Background: Malondialdehyde-modified low-density lipoprotein (MDA-LDL) is a predictive marker of cardiovascular events in patients with stable angina pectoris. However, little is known about this marker in patients with acute coronary syndrome (ACS). We investigated the prognostic relevance of MDA-LDL to cardiovascular outcomes in patients with ACS. Methods: A total of 370 consecutive patients with ACS who underwent primary percutaneous coronary intervention (PCI) were enrolled from October 2009 to September 2014 at Mitoyo General Hospital. Serum MDA-LDL levels were measured at admission. The patients were divided into three tertile groups according to serum MDA-LDL levels. The primary outcomes were cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, revascularization, and heart failure requiring hospital admission. Results: MDA-LDL levels in patients with acute myocardial infarction were significantly greater than those in patients with unstable angina pectoris (mean ± standard deviation: 133 ± 48 U/L vs. 157 ± 69 U/L, p = 0.001). During follow-up [472 (195–920) days], 82 (22{\%}) events occurred. Kaplan–Meier analysis showed that patients in the highest MDA-LDL tertile had the worst prognosis (log-rank, p < 0.001). Cox regression analysis showed that serum MDA-LDL levels were an independent predictor of cardiovascular events after PCI in patients with ACS, even after adjustment for age, sex, body mass index, conventional cardiovascular risk factors, other lipid biomarkers, statin use on admission, cardiac biomarkers, and presence or absence of multivessel disease (hazard ratio: 1.80 per 1 standard deviation U/L increase, 95{\%} confidence interval: 1.07–3.16, p = 0.027). Conclusion: Serum MDA-LDL levels on admission are a significant prognostic marker in patients with ACS who undergo successful PCI.",
keywords = "Coronary artery disease, Oxidized low-density lipoprotein, Percutaneous coronary intervention, Prognosis",
author = "Naofumi Amioka and Toru Miyoshi and Hiroaki Otsuka and Daisuke Yamada and Atsushi Takaishi and Masayuki Ueeda and Satoshi Hirohata and Hiroshi Itoh",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jjcc.2019.02.012",
language = "English",
journal = "Journal of cardiography. Supplement",
issn = "0914-5087",
publisher = "Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)",

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TY - JOUR

T1 - Serum malondialdehyde-modified low-density lipoprotein levels on admission predict prognosis in patients with acute coronary syndrome undergoing percutaneous coronary intervention

AU - Amioka, Naofumi

AU - Miyoshi, Toru

AU - Otsuka, Hiroaki

AU - Yamada, Daisuke

AU - Takaishi, Atsushi

AU - Ueeda, Masayuki

AU - Hirohata, Satoshi

AU - Itoh, Hiroshi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Malondialdehyde-modified low-density lipoprotein (MDA-LDL) is a predictive marker of cardiovascular events in patients with stable angina pectoris. However, little is known about this marker in patients with acute coronary syndrome (ACS). We investigated the prognostic relevance of MDA-LDL to cardiovascular outcomes in patients with ACS. Methods: A total of 370 consecutive patients with ACS who underwent primary percutaneous coronary intervention (PCI) were enrolled from October 2009 to September 2014 at Mitoyo General Hospital. Serum MDA-LDL levels were measured at admission. The patients were divided into three tertile groups according to serum MDA-LDL levels. The primary outcomes were cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, revascularization, and heart failure requiring hospital admission. Results: MDA-LDL levels in patients with acute myocardial infarction were significantly greater than those in patients with unstable angina pectoris (mean ± standard deviation: 133 ± 48 U/L vs. 157 ± 69 U/L, p = 0.001). During follow-up [472 (195–920) days], 82 (22%) events occurred. Kaplan–Meier analysis showed that patients in the highest MDA-LDL tertile had the worst prognosis (log-rank, p < 0.001). Cox regression analysis showed that serum MDA-LDL levels were an independent predictor of cardiovascular events after PCI in patients with ACS, even after adjustment for age, sex, body mass index, conventional cardiovascular risk factors, other lipid biomarkers, statin use on admission, cardiac biomarkers, and presence or absence of multivessel disease (hazard ratio: 1.80 per 1 standard deviation U/L increase, 95% confidence interval: 1.07–3.16, p = 0.027). Conclusion: Serum MDA-LDL levels on admission are a significant prognostic marker in patients with ACS who undergo successful PCI.

AB - Background: Malondialdehyde-modified low-density lipoprotein (MDA-LDL) is a predictive marker of cardiovascular events in patients with stable angina pectoris. However, little is known about this marker in patients with acute coronary syndrome (ACS). We investigated the prognostic relevance of MDA-LDL to cardiovascular outcomes in patients with ACS. Methods: A total of 370 consecutive patients with ACS who underwent primary percutaneous coronary intervention (PCI) were enrolled from October 2009 to September 2014 at Mitoyo General Hospital. Serum MDA-LDL levels were measured at admission. The patients were divided into three tertile groups according to serum MDA-LDL levels. The primary outcomes were cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, revascularization, and heart failure requiring hospital admission. Results: MDA-LDL levels in patients with acute myocardial infarction were significantly greater than those in patients with unstable angina pectoris (mean ± standard deviation: 133 ± 48 U/L vs. 157 ± 69 U/L, p = 0.001). During follow-up [472 (195–920) days], 82 (22%) events occurred. Kaplan–Meier analysis showed that patients in the highest MDA-LDL tertile had the worst prognosis (log-rank, p < 0.001). Cox regression analysis showed that serum MDA-LDL levels were an independent predictor of cardiovascular events after PCI in patients with ACS, even after adjustment for age, sex, body mass index, conventional cardiovascular risk factors, other lipid biomarkers, statin use on admission, cardiac biomarkers, and presence or absence of multivessel disease (hazard ratio: 1.80 per 1 standard deviation U/L increase, 95% confidence interval: 1.07–3.16, p = 0.027). Conclusion: Serum MDA-LDL levels on admission are a significant prognostic marker in patients with ACS who undergo successful PCI.

KW - Coronary artery disease

KW - Oxidized low-density lipoprotein

KW - Percutaneous coronary intervention

KW - Prognosis

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