pISSN 1738-5520 eISSN 1738-5555
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    Korean Circ J. 2008 Sep;38(9):475-482. Korean.
    Published online Sep 30, 2008.
    https://doi.org/10.4070/kcj.2008.38.9.475
    Copyright © 2008 The Korean Society of Cardiology
    Original Article

    The Clinical Value of Modified Low Density Lipoprotein-Cholesterol in Patients Who Underwent Percutaneous Coronary Intervention

    Nam Sik Yoon, MD, Myung Ho Jeong, MD, Young Aeh Kim, MT, Woo Suk Lee, MD, Sun Ho Hwang, MD, Sang Rok Lee, MD, Seo Na Hong, MD, Kye Hun Kim, MD, Hyung Wook Park, MD, Ju Han Kim, MD, Young Keun Ahn, MD, Jeong Gwan Cho, MD, Jong Chun Park, MD and Jung Chaee Kang, MD
      • The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
    • Correspondence: Myung Ho Jeong, MD, The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, 8 Hak 1-dong, Dong-gu, Gwangju 501-757, Korea. Tel: 82-62-220-6243, Fax: 82-62-228-7174, Email: myungho@chollian.net
    Received June 15, 2007; Revised February 12, 2008; Accepted April 23, 2008.

    Abstract

    Background and Objectives

    It is well known that atherosclerosis is characterized by chronic inflammation of an injured intima and the pathological processes are initiated by an accumulation of morphologically distinct, modified forms of low density lipoprotein (LDL)-cholesterol. However, it is not well known whether the level of modified LDL-cholesterol has clinical significance for the patients who underwent percutaneous coronary intervention (PCI).

    Subjects and Methods

    Eighty seven patients (mean age: 63.0 ± 11.1 years, 58 men) who underwent PCI were enrolled. The patients with stable or unstable angina pectoris were classified as group I (n=44, mean age: 62.4 ± 9.3 years), and the patients with acute myocardial infarction were classified as group II (n=43, mean age: 63.6 ± 12.7 years). Modified LDL-cholesterol was expressed semiquantitatively by agarose gel electrophoresis with using the charge modification frequency (CMF). The clinical and coronary angiographic data was analyzed.

    Results

    The clinical diagnosis was stable angina in 13 patients, unstable angina in 31 patients, non-ST elevation myocardial infarction in 5 patients and ST elevation myocardial infarction in 38 patients. There were no significant differences of the CMF between two groups (3.0 ± 7.9 vs. 2.1 ± 10.9, respectively, p=0.671). The diameter stenosis was severe in the patients with a CMF greater than 10 (84.0 ± 10.4% vs. 78.6 ± 13.7%, respectively, p=0.047). The six-month major adverse cardio-vascular events (MACEs) had no relationship with the CMF in group I. However, in group II, the 6-month MACEs developed more frequently in the patients with a CMF higher than 10 {2 (28%) for group ll vs. 2 (5%) for group 1, p=0.031}. The patients with acute myocardial infarction and whose CMF was higher than 10 had in-stent restenosis observed on their follow-up coronary angiography (p=0.003).

    Conclusion

    A higher level of modified LDL-cholesterol is associated with severe angiographic findings and a poor prognosis for patients with acute myocardial infarction.

    Keywords
    Lipoprotein; Acute coronary syndrome

    Figures

    Fig. 1
    Calculation of the charge modification frequency on the agarose gel electrophoresis. LDL-C: low density lipoprotein-cholesterol.

    Fig. 2
    Two examples of the charge modification frequency on the agarose gel electrophoresis. A: CMF=0. B: CMF=54. CH: cholesterol, TG: triglyceride, LDL-C: low density lipoprotein-cholesterol, HDL-C: high density lipoprotein-cholesterol, VLDL-C: very low density lipoprotein-cholesterol, CHYLO: chylomicron.

    Tables

    Table 1
    Baseline clinical characteristics

    Table 2
    Lipid profile

    Table 3
    Coronary angiographic findings according to the CMF

    Table 4
    Baseline clinical characteristics according to the CMF

    Table 5
    Coronary angiographic finding according to the level of charge modification frequency (CMF)

    Table 6
    Coronary angiographic findings

    Table 7
    Coronary angiographic follow-up and the in-stent restenosis

    Table 8
    Coronary angiographic findings and six-month MACEs in the patients with myocardial infarction according to the level of CMF

    Table 9
    Coronary angiographic findings and the six-month MACEs in patients with angina pectoris, according to the level of CMF

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    MeSH Terms
    Acute Coronary Syndrome
    Angina, Stable
    Angina, Unstable
    Atherosclerosis
    Constriction, Pathologic
    Coronary Angiography
    Electrophoresis, Agar Gel
    Fees and Charges
    Follow-Up Studies
    Humans
    Inflammation
    Lipoproteins
    Myocardial Infarction
    Pathologic Processes
    Percutaneous Coronary Intervention
    Prognosis
    Metrics
    Share
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