Korean Circ J.  2008 Sep;38(9):475-482. 10.4070/kcj.2008.38.9.475.

The Clinical Value of Modified Low Density Lipoprotein-Cholesterol in Patients Who Underwent Percutaneous Coronary Intervention

• Yoon NS
• Jeong MH
• Kim YA
• Lee WS
• Hwang SH
• Lee SR
• Hong SN
• Kim KH
• Park HW
• Kim JH
• Ahn YK
• Cho JG
• Park JC
• Kang JC

• KMID: 1776348
• DOI: http://doi.org/10.4070/kcj.2008.38.9.475

Abstract

BACKGROUND AND OBJECTIVES
It is well known that atherosclerosis is characterized by chronic inflammation of an injured intima and the pathological processes are initiated by an accumulation of morphologically distinct, modified forms of low density lipoprotein (LDL)-cholesterol. However, it is not well known whether the level of modified LDL-cholesterol has clinical significance for the patients who underwent percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: Eighty seven patients (mean age: 63.0 +/- 11.1 years, 58 men) who underwent PCI were enrolled. The patients with stable or unstable angina pectoris were classified as group I (n=44, mean age: 62.4 +/- 9.3 years), and the patients with acute myocardial infarction were classified as group II (n=43, mean age: 63.6 +/- 12.7 years). Modified LDL-cholesterol was expressed semiquantitatively by agarose gel electrophoresis with using the charge modification frequency (CMF). The clinical and coronary angiographic data was analyzed. RESULTS: The clinical diagnosis was stable angina in 13 patients, unstable angina in 31 patients, non-ST elevation myocardial infarction in 5 patients and ST elevation myocardial infarction in 38 patients. There were no significant differences of the CMF between two groups (3.0 +/- 7.9 vs. 2.1 +/- 10.9, respectively, p=0.671). The diameter stenosis was severe in the patients with a CMF greater than 10 (84.0 +/- 10.4% vs. 78.6 +/- 13.7%, respectively, p=0.047). The six-month major adverse cardio-vascular events (MACEs) had no relationship with the CMF in group I. However, in group II, the 6-month MACEs developed more frequently in the patients with a CMF higher than 10 {2 (28%) for group ll vs. 2 (5%) for group 1, p=0.031}. The patients with acute myocardial infarction and whose CMF was higher than 10 had in-stent restenosis observed on their follow-up coronary angiography (p=0.003). CONCLUSION: A higher level of modified LDL-cholesterol is associated with severe angiographic findings and a poor prognosis for patients with acute myocardial infarction.

Keyword

Lipoprotein; Acute coronary syndrome

MeSH Terms

Acute Coronary Syndrome
Angina, Stable
Angina, Unstable
Atherosclerosis
Constriction, Pathologic
Coronary Angiography
Electrophoresis, Agar Gel
Fees and Charges
Follow-Up Studies
Humans
Inflammation
Lipoproteins
Myocardial Infarction
Pathologic Processes
Percutaneous Coronary Intervention
Prognosis
Lipoproteins

Figure

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  Fig. 1 Calculation of the charge modification frequency on the agarose gel electrophoresis. LDL-C: low density lipoprotein-cholesterol.

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  Fig. 2 Two examples of the charge modification frequency on the agarose gel electrophoresis. A: CMF=0. B: CMF=54. CH: cholesterol, TG: triglyceride, LDL-C: low density lipoprotein-cholesterol, HDL-C: high density lipoprotein-cholesterol, VLDL-C: very low density lipoprotein-cholesterol, CHYLO: chylomicron.

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