We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Malondialdehyde-modified LDL as a marker of acute coronary syndromes.
- Authors
Holvoet, Paul; Collen, Desire; Van de Werf, Frans; Holvoet, P; Collen, D; Van de Werf, F
- Abstract
<bold>Context: </bold>Release of circulating malondialdehyde (MDA)-modified low-density lipoprotein (LDL) may reflect endothelial injury or plaque instability.<bold>Objective: </bold>To determine the usefulness of MDA-modified LDL for identifying patients with unstable angina and acute myocardial infarction (AMI).<bold>Design: </bold>Blinded comparison of MDA-modified LDL, C-reactive protein, and troponin I followed by multiple receiver operating curve analysis.<bold>Setting: </bold>University hospital.<bold>Participants: </bold>A total of 104 consecutive patients with acute coronary syndromes (42 with unstable angina and 62 with AMI), and 64 patients with stable coronary artery disease (CAD) without evidence of ischemia.<bold>Main Outcome Measures: </bold>Ability of MDA-modified LDL, C-reactive protein, and troponin I to discriminate patients with stable CAD, unstable angina, or AMI.<bold>Results: </bold>Malondialdehyde-modified LDL (chi2 = 10.2; P = .001), but not troponin I or C-reactive protein, discriminated between stable CAD and unstable angina. Troponin I (chi2 = 14.5; P<.001), but not MDA-modified LDL or C-reactive protein, discriminated between unstable angina and AMI. Both MDA-modified LDL and troponin I (chi2 = 14.5; P<.001 and chi2 = 5.3; P = .02, respectively) but not C-reactive protein discriminated between stable CAD and AMI. The sensitivity of MDA-modified LDL was 95% for unstable angina and 95% for AMI, with a specificity of 95%. Values for troponin I were 38% and 90%, respectively, with a specificity of 95%. The combination of MDA-modified LDL and troponin I had a sensitivity of 98% for unstable angina and 100% for AMI, with a specificity of 99%.<bold>Conclusion: </bold>The combination of MDA-modified LDL, which may reflect endothelial injury or plaque instability, and troponin I, which reflects myocardial cell injury, allows better discrimination between stable CAD and acute coronary syndromes than troponin I alone.
- Subjects
LIPOPROTEINS; MYOCARDIAL infarction diagnosis; HEART diseases; ANGINA pectoris
- Publication
JAMA: Journal of the American Medical Association, 1999, Vol 281, Issue 18, p1718
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.281.18.1718