Increased Circulating Malondialdehyde-Modified Low-Density Lipoprotein Level Is Associated with High-Risk Plaque in Coronary Computed Tomography Angiography in Patients Receiving Statin Therapy
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
APA StyleIchikawa, K., Miyoshi, T., Osawa, K., Miki, T., & Ito, H. (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(7), 1480. https://doi.org/10.3390/jcm10071480