Oxidized-LDL/β2-Glycoprotein I Complexes Are Associated With Disease Severity and Increased Risk for Adverse Outcomes in Patients With Acute Coronary Syndromes

Oxidized low-density lipoprotein (oxLDL)/ β 2 -glycoprotein I (β2GPI) complexes have been implicated in atherogenesis. oxLDL1/β2GP1 complexes were measured in 339 patients with suspected acute coronary syndromes. Approximately 68% had angiographically documented coronary artery disease (CAD) and significantly higher mean ± SD levels of oxLDL1/β2GP1 (3.75 ± 6.31 U/mL) than patients with normal coronary arteries (2.21 ± 3.03 U/mL; P = .0026). Patients with severe CAD had significantly higher mean ± SD levels of oxLDL1/β2GPI (8.71 ± 12.87 U/mL) compared with the overall mean of 3.25 U/mL (P < . 05) and a significantly higher rate (28.9%) of adverse events than the overall rate of 11.2% (P < .05). Patients with adverse events had higher mean ± SD levels of oxLDL1/β2GPI (4.05 ± 5.38 U/mL) than patients without adverse events (3.15 ± 5.53; P = . 029). The relative risk for adverse events in higher oxLDL1/β2GPI quartiles was 3.1 (95% confidence interval, 1.0-9.1; P = .06) for quartile 3 and 3.5 (95% confidence interval, 1.2-10.4; P = . 02) for quartile 4. Our results support the concept that oxLDL1/β2GP1 complexes are associated with severity of CAD and a 3.5-fold increased risk for adverse outcomes.