Plasma oxidized LDL: a predictor for acute myocardial infarction?

Objectives. Oxidized LDL has been attributed a key role in the development of atherosclerosis. Previous studies have demonstrated increased plasma levels of oxidized LDL in patients with established coronary artery disease. The aim of the present study was to investigate if plasma oxidized LDL also predicts risk for development of coronary heart disease (CHD). Design. We used a nested case-control design to study the association between plasma levels of oxidized LDL and risk for development of acute myocardial infarction (AMI) and/or death by CHD. Subjects. Oxidized LDL was analysed by ELISA in cases (n=26), controls (n=26) and controls with LDL cholesterol >5.0 mmol L-1 (n=26). Results. Oxidized LDL correlated with total plasma and LDL cholesterol in both cases (r=0.72, P<0.01, r=0.69, P<0.01, respectively) and controls (r=0.71, P<0.01, r=0.77, P<0.01, respectively). The oxidized LDL/plasma cholesterol ratio was higher amongst cases (13.5, range 10.7-19.8) than in controls (12.6, range 9.5-15.8, P<0.05) and hypercholesterolaemic controls (12.2, range 8.0-16.0, P<0.01). Conclusions. These findings identify high plasma oxidized LDL/total cholesterol ratio as a possible indicator of increased risk for AMI.