Increased Circulating Malondialdehyde-Modified Low-Density Lipoprotein Level Is Associated with High-Risk Plaque in Coronary Computed Tomography Angiography in Patients Receiving Statin Therapy
<p>Study flowchart. CTA, computed tomography angiography; CVD, cardiovascular disease; MDA-LDL, malondialdehyde-modified low-density lipoprotein.</p> "> Figure 2
<p>The prevalence of coronary plaque characteristics according to MDA-LDL and LDL-C. (<b>A</b>) Patients were divided into two groups based on the median value of MDA-LDL. (<b>B</b>) Patients were divided into two groups based on the median value of LDL-C. MDA-LDL, malondialdehyde-modified low-density lipoprotein; LDL-C, low-density lipoprotein cholesterol; CP, calcified plaque; NCP, non-calcified plaque; LDP, low density plaque; PR, positive remodeling; SC, spotty calcification; HRP, high-risk plaque: SS, significant stenosis.</p> "> Figure 3
<p>Kaplan–Meier curves of cumulative incidence of cardiovascular events. Kaplan–Meier curves (<b>A</b>) according to low or high MDA-LDL, and (<b>B</b>) according to low or high LDL-C. MDA-LDL, malondialdehyde-modified low-density lipoprotein; LDL-C, low-density lipoprotein cholesterol.</p> ">
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population and Risk Assessment
2.2. Blood Sampling and the Measurement of MDA-LDL
2.3. Acquisition and Analyses of Coronary CTA Image
2.4. Outcome Data
2.5. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. MDA-LDL and Coronary CTA Findings
3.3. Prognostic Impact of HRP and MDA-LDL for Cardiovascular Events
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Patients | High MDA-LDL (≥93 U/L) | Low MDA-LDL (<93 U/L) | p-Value | |
---|---|---|---|---|
n | 268 | 139 | 129 | |
Age, year | 67 ± 11 | 67 ± 11 | 68 ± 11 | 0.521 |
Male sex | 154 (58) | 76 (55) | 78 (61) | 0.338 |
Body mass index, kg/m2 | 24.6 ± 4.1 | 25.2 ± 3.9 | 24.0 ± 4.2 | 0.016 |
Hypertension | 203 (76) | 109 (78) | 94 (73) | 0.290 |
Diabetes mellitus | 122 (46) | 59 (42) | 63 (49) | 0.294 |
Current Smoker | 70 (26) | 36 (26) | 34 (26) | 0.932 |
Medications | ||||
Beta blockers | 71 (27) | 37 (27) | 34 (26) | 0.933 |
CCBs | 122 (46) | 70 (50) | 52 (40) | 0.099 |
ACE-Is or ARBs | 135 (50) | 73 (53) | 62 (48) | 0.466 |
Oral antihyperglycemic drugs | 86 (32) | 45 (32) | 41 (32) | 0.918 |
Ezetimibe | 15 (6) | 10 (7) | 5 (4) | 0.293 |
Statin intensity, low/moderate * | 160 (60)/108 (40) | 76 (55)/63 (45) | 84 (65)/45 (35) | 0.082 |
Statin type, dosage | ||||
Atorvastatin, 5 mg/10 mg | 18/49 | 5/26 | 13/23 | |
Fluvastatin, 20 mg/40 mg | 4/1 | 3/1 | 1/0 | |
Pitavastatin, 1 mg/2 mg/4 mg | 14/28/4 | 6/13/3 | 8/15/1 | |
Pravastatin, 5 mg/10 mg | 9/36 | 5/21 | 4/15 | |
Rosuvastatin, 2.5 mg/5 mg/10 mg | 68/24/2 | 30/19/2 | 38/5/0 | |
Simvastatin, 5 mg/10 mg | 8/3 | 4/1 | 4/2 | |
Laboratory findings | ||||
Creatinine, mg/dL | 0.89 ± 0.78 | 0.85 ± 0.64 | 0.93 ± 0.92 | 0.397 |
eGFR, mL/min/1.73 m2 | 68 ± 18 | 68 ± 17 | 69 ± 19 | 0.665 |
Total cholesterol, mg/dL | 186 ± 40 | 203 ± 40 | 168 ± 31 | <0.001 |
LDL cholesterol, mg/dL | 107 ± 32 | 122 ± 33 | 90 ± 22 | <0.001 |
HDL cholesterol, mg/dL | 58 ± 17 | 57 ± 17 | 60 ± 17 | 0.080 |
Triglyceride, mg/dL | 121 (88, 171) | 150 (104, 198) | 101 (76, 130) | <0.001 |
MDA-LDL, U/L | 96 ± 35 | 122 ± 28 | 69 ± 15 | <0.001 |
HbA1c, % | 6.6 ± 1.3 | 6.6 ± 1.4 | 6.6 ± 1.3 | 0.968 |
hsCRP, mg/dL | 0.08 (0.05, 0.18) | 0.08 (0.04, 0.16) | 0.08 (0.05, 0.20) | 0.608 |
Patients achieving LDLcholesterol <70 mg/dL | 24 (9) | 1 (1) | 23 (18) | <0.001 |
Variables | High-Risk Plaque | Significant Stenosis | ||||
---|---|---|---|---|---|---|
Present | Absent | p Value | Present | Absent | p Value | |
n | 87 | 181 | 119 | 148 | ||
Age, year | 68 ± 10 | 67 ± 12 | 0.747 | 68 ± 11 | 67 ± 12 | 0.489 |
Male sex | 64 (74) | 90 (50) | <0.001 | 84 (70) | 70 (47) | <0.001 |
Body mass index, kg/m2 | 24.7 ± 3.4 | 24.5 ± 4.4 | 0.718 | 24.4 ± 4.1 | 24.7 ± 4.1 | 0.450 |
Hypertension | 73 (84) | 130 (76) | 0.031 | 93 (78) | 110 (74) | 0.546 |
Diabetes mellitus | 48 (55) | 74 (41) | 0.028 | 63 (53) | 59 (40) | 0.039 |
Current smoker | 29 (33) | 41 (23) | 0.062 | 32 (27) | 38 (25) | 0.854 |
Oral antihyperglycemic drugs | 32 (37) | 54 (30) | 0.254 | 42 (35) | 44 (30) | 0.333 |
Creatinine, mg/dL | 1.00 ± 0.99 | 0.83 ± 0.65 | 0.087 | 0.91 ± 0.71 | 0.88 ± 0.83 | 0.066 |
Total cholesterol, mg/dL | 186 ± 45 | 187 ± 38 | 0.834 | 183 ± 41 | 188 ± 38 | 0.300 |
LDL cholesterol, mg/dL | 107 ± 37 | 107 ± 30 | 0.867 | 106 ± 34 | 107 ± 31 | 0.728 |
HDL cholesterol, mg/dL | 55 ± 16 | 60 ± 17 | 0.014 | 58 ± 18 | 58 ± 16 | 0.905 |
Triglyceride, mg/dL | 130 (90, 182) | 117 (85, 170) | 0.206 | 118 (86, 158) | 122 (89, 183) | 0.155 |
MDA-LDL, U/L | 105 ± 40 | 92 ± 32 | 0.011 | 96 ± 33 | 96 ± 36 | 0.979 |
HbA1c, % | 6.7 ± 1.3 | 6.5 ± 1.4 | 0.347 | 6.6 ± 1.3 | 6.5 ± 1.4 | 0.122 |
hsCRP, mg/dL | 0.08 (0.05, 0.16) | 0.08 (0.04, 0.19) | 0.907 | 0.09 (0.05, 0.200) | 0.07 (0.040, 0.160) | 0.132 |
Univariate | Multivariate | |||
---|---|---|---|---|
Odds Ratio (95%CI) | p Value | Odds Ratio (95%CI) | p Value | |
Age, per 1 year | 1.004 (0.981–1.028) | 0.746 | ||
Male | 2.814 (1.609–4.918) | <0.001 | 2.749 (1.502–1.502) | 0.001 |
Hypertension | 2.046 (1.060–3.947) | 0.033 | 2.027 (1.022–4.019) | 0.049 |
Diabetes Mellitus | 1.780 (1.062–2.982) | 0.029 | 1.630 (0.941–2.824) | 0.081 |
Current smoker | 1.707 (0.970–3.006) | 0.064 | ||
HDL cholesterol, per 1 mg/dL | 0.980 (0.964–0.996) | 0.015 | 0.994 (0.977–1.012) | 0.531 |
LDL cholesterol, >104 mg/dL | 0.807 (0.483–1.347) | 0.412 | ||
Triglyceride *, per 1 index | 1.454 (0.854–2.475) | 0.168 | ||
MDA-LDL, >93 U/L | 1.722 (1.024–2.897) | 0.041 | 1.883 (1.082–3.279) | 0.025 |
hsCRP *, per 1 index | 0.983 (0.793–1.219) | 0.878 |
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Ichikawa, K.; Miyoshi, T.; Osawa, K.; Miki, T.; Ito, H. Increased Circulating Malondialdehyde-Modified Low-Density Lipoprotein Level Is Associated with High-Risk Plaque in Coronary Computed Tomography Angiography in Patients Receiving Statin Therapy. J. Clin. Med. 2021, 10, 1480. https://doi.org/10.3390/jcm10071480
Ichikawa K, Miyoshi T, Osawa K, Miki T, Ito H. Increased Circulating Malondialdehyde-Modified Low-Density Lipoprotein Level Is Associated with High-Risk Plaque in Coronary Computed Tomography Angiography in Patients Receiving Statin Therapy. Journal of Clinical Medicine. 2021; 10(7):1480. https://doi.org/10.3390/jcm10071480
Chicago/Turabian StyleIchikawa, Keishi, Toru Miyoshi, Kazuhiro Osawa, Takashi Miki, and Hiroshi Ito. 2021. "Increased Circulating Malondialdehyde-Modified Low-Density Lipoprotein Level Is Associated with High-Risk Plaque in Coronary Computed Tomography Angiography in Patients Receiving Statin Therapy" Journal of Clinical Medicine 10, no. 7: 1480. https://doi.org/10.3390/jcm10071480