Impact of baseline level of 7-ketocholesterol on the rate of coronary reintervention in coronary artery disease patients--results of an observational study with questionnaire-based follow up.

INTRODUCTION: The aim of study was to assess the relation between plasma level of one of the oxysterols--7-ketocholesterol and angiographically evidenced coronary artery disease. MATERIAL AND METHODS: We measured plasma level of 7-ketocholesterol, malondialdehyde, total cholesterol, HDL cholesterol, triglycerides, erythrocyte activity of superoxide dismutase in 233 patients who previously underwent coronary angiography for diagnosis of coronary artery disease. The follow-up of patients (28 months) was done on basis of questionnaires sent out to them. RESULTS: We found that the subgroup of patients with 7-ketocholesterol above the median value (62 ng/mL) has higher rate of coronary reintervention (8/54 pts vs. 5/43 pts in 7-ketocholesterol below 62 ng/mL respectively, p = 0.284 Log-rank test). The finding was more pronounced, yet insignificant, in the subgroup of patients who underwent primary PTCA (6/19 pts vs. 2/20 pts, p = 0.1 Log-rank test). There were 3 patients in high 7-ketocholesterol subgroup who entered the study with previously undergone primary coronary intervention. There were not such patients in low 7-ketocholesterol subgroup. 4 deaths were observed in high 7-ketocholesterol subgroup, and one in low 7-ketocholesterol subgroup (they were predominantly not of cardiovascular origin). CONCLUSIONS: We failed to find a significant relation between 7-ketocholesterol and coronary artery disease, though there is a trend of such relation in patients who undergo PTCA, evidenced by a slightly higher number of repeated revascularizations among patients with high 7-ketocholesterol. The study indicates the areas of further studies with agents capable of lowering oxysterols and assessing also other end points.