Increased Serum Malondialdehyde-Modified Low-Density Lipoprotein and Coronary Angiographic Progression After Drug-Eluting Stent Implantation in Patients With Stable Angina

• Published in: Circulation Journal Vol. 84; no. 10; pp. 1837 - 1845
• Main Authors: Yokoi, Masashi, Ito, Tsuyoshi, Fujita, Hiroshi, Sugiura, Tomonori, Seo, Yoshihiro, Ohte, Nobuyuki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 25.09.2020
• Subjects: Aged; Aged, 80 and over; Angina, Stable - epidemiology; Angina, Stable - pathology; Angina, Stable - surgery; Angiographic progression; Biomarkers - blood; Coronary Angiography - methods; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary Artery Disease - etiology; Disease Progression; Drug-Eluting Stents - adverse effects; Female; Follow-Up Studies; Humans; Japan - epidemiology; Lipoproteins, LDL - blood; Male; Malondialdehyde - analogs & derivatives; Malondialdehyde - blood; Malondialdehyde-modified low-density lipoprotein; Middle Aged; Percutaneous Coronary Intervention - adverse effects; Plaque, Atherosclerotic - diagnostic imaging; Plaque, Atherosclerotic - epidemiology; Plaque, Atherosclerotic - etiology; Quantitative coronary angiography; Retrospective Studies; Japan; Angiographic progression; Quantitative coronary angiography; Malondialdehyde-modified low-density lipoprotein; Coronary artery disease
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-20-0060

Background:Cardiac events can occur after drug-eluting stent (DES) implantation due to coronary plaque progression at non-stented sites. Malondialdehyde-modified low-density lipoprotein (MDA-LDL) is suggested to be an atherogenic marker. This study investigated the relationship between serum MDA-LDL and angiographic progression after DES implantation.Methods and Results:In total, 207 patients who underwent percutaneous coronary intervention (PCI) using DES and follow-up coronary angiography were retrospectively analyzed. MDA-LDL was serially measured before PCI and at follow up. Persistent high MDA-LDL was defined as a MDA-LDL level more than the median value both before PCI and at follow up. Angiographic progression was assessed by serial analysis of quantitative coronary angiography. Angiographic progression occurred in 35 patients (16.9%). MDA-LDL before PCI was significantly higher in the progression group than the non-progression group in all patients (143.4±35.8 U/L vs. 103.0±33.5U/L, P<0.001) and in patients with controlled LDL-cholesterol (LDL-C <100 mg/dL both before PCI and at follow up; 121.8±32.7 U/L vs. 84.9±24.9 U/L, P<0.001). There were positive correlations between % diameter stenosis changes and serum MDA-LDL before PCI in all patients (r=0.33, P<0.01) and those with controlled LDL-C (r=0.23, P=0.04). In multivariate logistic regression analysis, persistent high MDA-LDL was an independent predictor of plaque progression.Conclusions:Increased serum MDA-LDL was associated with angiographic progression after DES implantation.