The complex link between oxidised low-density lipoprotein and unstable angina

Giampaolo Niccoli, Rocco Mongiardo, Gaetano A. Lanza, Annalisa Ricco, Francesco Burzotta, Carlo Trani, Mario A. Mazzari, Giovanna Liuzzo, Antonella Lombardo, Antonio G. Rebuzzi, Paul Holvoet, Filippo Crea

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Abstract

OBJECTIVE: The role of oxidised low-density lipoprotein (ox-LDL) in plaque destabilisation is controversial; therefore we aimed at comparing plaque and plasma ox-LDL content in stable and unstable ischaemic syndromes. We also assessed the correlation between plaque or plasma ox-LDL and angiographic complex stenosis morphology. METHODS: Ten consecutive patients with chronic stable angina (SA) and 10 consecutive patients with unstable angina (UA) were studied. Plaque sections obtained by directional coronary atherectomy were immunostained with the monoclonal antibody mAb-4E6, which recognises several oxidation epitopes on LDL (mAb-4E6 ox-LDL), and with the monoclonal antibody mAb-1H11 (mAb-1H11 ox-LDL), which recognises malondialdehyde-modified LDL. An mAb-4E6-based competition ELISA was used for quantification of ox-LDL in plasma. C-reactive protein serum levels were measured by a high-sensitivity nephelometric assay. An angiographic analysis was performed to assess severity and extent of coronary atherosclerotic disease and stenosis morphology. RESULTS: Percent plaque area occupied by mAb-4E6 ox-LDL or mAb-1H11 ox-LDL was similar in patients with SA or UA (22.4 ± 13.1 vs. 21.1 ± 19.7%, P = 0.8 and 19.3 ± 10.4 vs. 16.8 ± 16.9%, P = 0.6, respectively), whereas ox-LDL plasma levels were significantly higher in patients with UA than in patients with SA (2.4 ± 1.1 vs. 0.9 ± 0.6 mg/dl; P = 0.03). Furthermore, a significant correlation was found between plasma levels of ox-LDL and the number of angiographically complex lesions (P = 0.03) or C-reactive protein serum levels (P = 0.04). CONCLUSIONS: Neither plaque mAb-4E6 ox-LDL nor plaque mAb-1H11 ox-LDL seem to be a major trigger of coronary plaque instability. However, circulating ox-LDL might be involved in plaque vulnerability and coronary artery disease activity.

Original languageEnglish
Pages (from-to)387-391
Number of pages5
JournalJournal of Cardiovascular Medicine
Volume8
Issue number5
DOIs
Publication statusPublished - May 2007

Fingerprint

Unstable Angina
Stable Angina
oxidized low density lipoprotein
C-Reactive Protein
Monoclonal Antibodies
Coronary Atherectomy
Coronary Stenosis
Malondialdehyde
Serum
Coronary Disease
Coronary Artery Disease
Epitopes

Keywords

  • Coronary artery disease
  • Inflammation
  • Oxidized low-density lipoprotein
  • Unstable angina
  • Vulnerable plaque

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The complex link between oxidised low-density lipoprotein and unstable angina. / Niccoli, Giampaolo; Mongiardo, Rocco; Lanza, Gaetano A.; Ricco, Annalisa; Burzotta, Francesco; Trani, Carlo; Mazzari, Mario A.; Liuzzo, Giovanna; Lombardo, Antonella; Rebuzzi, Antonio G.; Holvoet, Paul; Crea, Filippo.

In: Journal of Cardiovascular Medicine, Vol. 8, No. 5, 05.2007, p. 387-391.

Research output: Contribution to journalArticle

Niccoli, G, Mongiardo, R, Lanza, GA, Ricco, A, Burzotta, F, Trani, C, Mazzari, MA, Liuzzo, G, Lombardo, A, Rebuzzi, AG, Holvoet, P & Crea, F 2007, 'The complex link between oxidised low-density lipoprotein and unstable angina', Journal of Cardiovascular Medicine, vol. 8, no. 5, pp. 387-391. https://doi.org/10.2459/01.JCM.0000268127.36295.04
Niccoli, Giampaolo ; Mongiardo, Rocco ; Lanza, Gaetano A. ; Ricco, Annalisa ; Burzotta, Francesco ; Trani, Carlo ; Mazzari, Mario A. ; Liuzzo, Giovanna ; Lombardo, Antonella ; Rebuzzi, Antonio G. ; Holvoet, Paul ; Crea, Filippo. / The complex link between oxidised low-density lipoprotein and unstable angina. In: Journal of Cardiovascular Medicine. 2007 ; Vol. 8, No. 5. pp. 387-391.
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abstract = "OBJECTIVE: The role of oxidised low-density lipoprotein (ox-LDL) in plaque destabilisation is controversial; therefore we aimed at comparing plaque and plasma ox-LDL content in stable and unstable ischaemic syndromes. We also assessed the correlation between plaque or plasma ox-LDL and angiographic complex stenosis morphology. METHODS: Ten consecutive patients with chronic stable angina (SA) and 10 consecutive patients with unstable angina (UA) were studied. Plaque sections obtained by directional coronary atherectomy were immunostained with the monoclonal antibody mAb-4E6, which recognises several oxidation epitopes on LDL (mAb-4E6 ox-LDL), and with the monoclonal antibody mAb-1H11 (mAb-1H11 ox-LDL), which recognises malondialdehyde-modified LDL. An mAb-4E6-based competition ELISA was used for quantification of ox-LDL in plasma. C-reactive protein serum levels were measured by a high-sensitivity nephelometric assay. An angiographic analysis was performed to assess severity and extent of coronary atherosclerotic disease and stenosis morphology. RESULTS: Percent plaque area occupied by mAb-4E6 ox-LDL or mAb-1H11 ox-LDL was similar in patients with SA or UA (22.4 ± 13.1 vs. 21.1 ± 19.7{\%}, P = 0.8 and 19.3 ± 10.4 vs. 16.8 ± 16.9{\%}, P = 0.6, respectively), whereas ox-LDL plasma levels were significantly higher in patients with UA than in patients with SA (2.4 ± 1.1 vs. 0.9 ± 0.6 mg/dl; P = 0.03). Furthermore, a significant correlation was found between plasma levels of ox-LDL and the number of angiographically complex lesions (P = 0.03) or C-reactive protein serum levels (P = 0.04). CONCLUSIONS: Neither plaque mAb-4E6 ox-LDL nor plaque mAb-1H11 ox-LDL seem to be a major trigger of coronary plaque instability. However, circulating ox-LDL might be involved in plaque vulnerability and coronary artery disease activity.",
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AU - Lanza, Gaetano A.

AU - Ricco, Annalisa

AU - Burzotta, Francesco

AU - Trani, Carlo

AU - Mazzari, Mario A.

AU - Liuzzo, Giovanna

AU - Lombardo, Antonella

AU - Rebuzzi, Antonio G.

AU - Holvoet, Paul

AU - Crea, Filippo

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N2 - OBJECTIVE: The role of oxidised low-density lipoprotein (ox-LDL) in plaque destabilisation is controversial; therefore we aimed at comparing plaque and plasma ox-LDL content in stable and unstable ischaemic syndromes. We also assessed the correlation between plaque or plasma ox-LDL and angiographic complex stenosis morphology. METHODS: Ten consecutive patients with chronic stable angina (SA) and 10 consecutive patients with unstable angina (UA) were studied. Plaque sections obtained by directional coronary atherectomy were immunostained with the monoclonal antibody mAb-4E6, which recognises several oxidation epitopes on LDL (mAb-4E6 ox-LDL), and with the monoclonal antibody mAb-1H11 (mAb-1H11 ox-LDL), which recognises malondialdehyde-modified LDL. An mAb-4E6-based competition ELISA was used for quantification of ox-LDL in plasma. C-reactive protein serum levels were measured by a high-sensitivity nephelometric assay. An angiographic analysis was performed to assess severity and extent of coronary atherosclerotic disease and stenosis morphology. RESULTS: Percent plaque area occupied by mAb-4E6 ox-LDL or mAb-1H11 ox-LDL was similar in patients with SA or UA (22.4 ± 13.1 vs. 21.1 ± 19.7%, P = 0.8 and 19.3 ± 10.4 vs. 16.8 ± 16.9%, P = 0.6, respectively), whereas ox-LDL plasma levels were significantly higher in patients with UA than in patients with SA (2.4 ± 1.1 vs. 0.9 ± 0.6 mg/dl; P = 0.03). Furthermore, a significant correlation was found between plasma levels of ox-LDL and the number of angiographically complex lesions (P = 0.03) or C-reactive protein serum levels (P = 0.04). CONCLUSIONS: Neither plaque mAb-4E6 ox-LDL nor plaque mAb-1H11 ox-LDL seem to be a major trigger of coronary plaque instability. However, circulating ox-LDL might be involved in plaque vulnerability and coronary artery disease activity.

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KW - Coronary artery disease

KW - Inflammation

KW - Oxidized low-density lipoprotein

KW - Unstable angina

KW - Vulnerable plaque

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