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Antibody Against Oxidized Low-Density Lipoprotein Predicting Myocardial Infarction

Marja Puurunen; Matti Mänttäri, MD; Vesa Manninen, MD; Leena Tenkanen, PhD; Georg Alfthan, PhD; Christian Ehnholm, MD; Outi Vaarala, MD; Kimmo Aho, MD; Timo Palosuo, MD
Arch Intern Med. 1994;154(22):2605-2609. doi:10.1001/archinte.1994.00420220105012.
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Background:  Oxidation of low-density lipoprotein is believed to be an important step in the pathogenesis of atherosclerosis. The purpose of the present study was to determine whether antibody against oxidized low-density lipoprotein, reported to be associated with the progression of carotid atherosclerosis, is predictive of cardiac death and nonfatal myocardial infarction.

Methods:  Serum samples from 135 cases and their controls, drawn at entry from middle-aged dyslipidemic men participating in the Helsinki Heart Study, a 5-year coronary primary prevention trial with gemfibrozil, were tested for immunoglobulin G class antibodies against oxidized low-density lipoprotein by enzyme-linked immunosorbent assay.

Results:  The mean antibody level, expressed in optical density units, was significantly higher in cases than in controls (0.412 vs 0.356, P=.002). After adjustment for age, smoking, blood pressure, and high-density lipoprotein cholesterol level, there was a 2.5-fold increased risk (95% confidence interval, 1.3 to 4.9) of a cardiac end point in the highest tertile of antibody level vs the lowest tertile (P=.005 for trend).

Conclusions:  Elevated levels of antibodies against oxidized low-density lipoprotein were predictive of myocardial infarction. The effect was independent of low-density lipoprotein cholesterol levels, and the joint effect was additive. Elevated antibody levels modified the effects of classic coronary risk factors.(Arch Intern Med. 1994;154:2605-2609)


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