Impact of Malondialdehyde-Modified Low-Density Lipoprotein on Tissue Characteristics in Patients With Stable Coronary Artery Disease　– Integrated Backscatter-Intravascular Ultrasound Study –

Hiroki Ikenaga; Satoshi Kurisu; Shingo Kono; Yoji Sumimoto; Noriaki Watanabe; Takashi Shimonaga; Tadanao Higaki; Toshitaka Iwasaki; Naoya Mitsuba; Ken Ishibashi; Yoshihiro Dohi; Yukihiro Fukuda; Yasuki Kihara

doi:10.1253/circj.CJ-16-0451

Ischemic Heart Disease

Impact of Malondialdehyde-Modified Low-Density Lipoprotein on Tissue Characteristics in Patients With Stable Coronary Artery Disease　– Integrated Backscatter-Intravascular Ultrasound Study –

Hiroki Ikenaga, Satoshi Kurisu, Shingo Kono, Yoji Sumimoto, Noriaki Watanabe, Takashi Shimonaga, Tadanao Higaki, Toshitaka Iwasaki, Naoya Mitsuba, Ken Ishibashi, Yoshihiro Dohi, Yukihiro Fukuda, Yasuki Kihara

Author information

Hiroki Ikenaga
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
Satoshi Kurisu
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
Shingo Kono
Clinical Support Department of Advanced Diagnostic Imaging, Hiroshima University Hospital
Yoji Sumimoto
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
Noriaki Watanabe
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
Takashi Shimonaga
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
Tadanao Higaki
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
Toshitaka Iwasaki
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
Naoya Mitsuba
Department of Cardiology, Hiroshima Prefectural Hospital
Ken Ishibashi
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
Yoshihiro Dohi
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
Yukihiro Fukuda
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
Yasuki Kihara
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences

Keywords: Coronary plaque vulnerability, Integrated backscatter-intravascular ultrasound, Malondialdehyde-modified low-density lipoprotein

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2016 Volume 80 Issue 10 Pages 2173-2182

DOI https://doi.org/10.1253/circj.CJ-16-0451

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Abstract

Background:Malondialdehyde-modified low-density lipoprotein (MDA-LDL) is considered to play an essential role in plaque destabilization. We aimed to investigate the association between the tissue characteristics of culprit plaque assessed by integrated backscatter (IB)-intravascular ultrasound (IVUS) and the serum MDA-LDL levels in patients with stable coronary artery disease.

Methods and Results:The study group consisted of 179 patients undergoing IB-IVUS during elective percutaneous coronary intervention. Patients were classified into 2 groups based on serum MDA-LDL level: low MDA-LDL group (<102 U/L, n=88) and high MDA-LDL group (≥102 U/L, n=91). Plaques in the high MDA-LDL group had higher %lipid (45.2±12.5% vs. 54.9±14.5%, P<0.001) and lower %fibrosis (43.0±9.1% vs. 36.4±11.4%, P<0.001) than did plaques in the low MDA-LDL group. Lipid-rich plaque (%lipid >60% or %fibrosis <30%) was significantly more frequently found in the high MDA-LDL group than in the low MDA-LDL group (14.3% vs. 39.8%, P<0.001). The incidence of MACE (cardiac death, myocardial infarction and/or hospitalization for heart failure) during 3 years was significantly higher in the high MDA-LDL group than in the low MDA-LDL group (6.6% vs. 15.9%, P=0.02).

Conclusions:Higher MDA-LDL might be associated with greater lipid and lower fibrous content, contributing to coronary plaque vulnerability. (Circ J 2016; 80: 2173–2182)

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