Antibodies to oxidized low-density lipoprotein in patients following coronary artery revascularization

Coron Artery Dis. 2003 Apr;14(2):163-9. doi: 10.1097/00019501-200304000-00009.


Background: Measurement of antibodies to oxidized low-density lipoprotein (AB-oxLDL) has been proposed as a way of identifying individuals at risk for cardiovascular disease beyond the determination of LDL cholesterol (LDL-c) alone. While this hypothesis is appealing, evidence that AB-oxLDL is a risk factor independent of LDL-c levels remains to be established.

Methods and results: We conducted a cross-sectional study of 158 hypercholesterolemic adults who underwent coronary revascularization. Patients were randomized in a clinical trial to a nurse case management (NURS) or an enhanced usual care (EUC) group. The goal in the NURS group was to achieve an LDL-c <85 mg/dl with pharmacotherapy and lifestyle advice. Six months after revascularization, serum and urine were collected to determine lipids, AB-oxLDL, urinary isoprostanes (an in-vivo marker of oxidative damage), oxygen-radical-absorbing capacity (ORAC) of serum, serum carotenoids, alpha-tocopherol and C-reactive protein (CRP). After 6 months of intervention, the NURS group had a mean (+/-SD) LDL-c of 84 (18) mg/dl compared with 105 (25) mg/dl in the EUC group (P < 0.001). In addition, AB-oxLDL was lower (median +/- 95% confidence interval, -202 milliunits (mU)/ml, -372 to -32, P = 0.02) in the NURS group (488 mU/ml, 399, 588) than in the EUC group (690 mU/ml, 544, 847). The difference in AB-oxLDL between groups persisted after adjustment for LDL-c (-316 mU/ml, -519 to -112, P = 0.005). Further adjustment for ORAC and alpha-tocopherol did not diminish the group effect. The groups did not differ significantly in serum antioxidants, urinary isoprostane excretion or CRP. In additional analyses, change in LDL-c from baseline was not associated with AB-oxLDL at 6 months.

Conclusions: Our results demonstrate lower AB-oxLDL in patients who achieve greater lipid reduction. However, AB-oxLDL appears to be independent of achieved LDL-c, ORAC levels or serum antioxidant levels. These results support the hypothesis that AB-oxLDL is independent of LDL-c level. Further prospective studies are needed to determine the prognostic value of AB-oxLDL.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Antibodies / blood*
  • Antibodies / drug effects
  • C-Reactive Protein / metabolism
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / drug therapy
  • Coronary Artery Disease / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / drug therapy
  • Hypercholesterolemia / surgery
  • Hypolipidemic Agents / therapeutic use
  • Lipoproteins, LDL / drug effects
  • Lipoproteins, LDL / immunology*
  • Male
  • Middle Aged
  • Myocardial Revascularization*
  • Oxidation-Reduction / drug effects
  • Predictive Value of Tests
  • Prospective Studies
  • Reactive Oxygen Species / blood
  • Statistics as Topic
  • Treatment Outcome
  • Triglycerides / blood


  • Antibodies
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypolipidemic Agents
  • Lipoproteins, LDL
  • Reactive Oxygen Species
  • Triglycerides
  • oxidized low density lipoprotein
  • C-Reactive Protein