Oxidized low density lipoprotein is a prognostic marker of transplant-associated coronary artery disease

Retrospective studies identified oxidized low density lipoprotein (LDL) in the blood asa diagnostic marker of coronary artery disease (CAD). This pros pective study sought to determine the prognostic value of oxidized LDL for CAD in cardiac transplant patients. Oxidized LDL was measured in 99 cardiac transplant patients with normal coronary angiograms at baseline and was me asured again after a median follow-up of 2 years at the time of a second an giogram. Twenty-one patients developed angiographically detectable cardiac transplant vasculopathy (cases), and 78 individuals did not (controls). Cas es had significantly higher baseline plasma levels of oxidized LDL than did controls: 1.18+/-0.70 versus 0.57+/-0.20 mg/dL (mean+/-SD, P<0.0001), The increase of oxidized LDL at the end of the follow-up was significantly high er in cases than in controls: 0.75+0.73 mg/dL versus 0.14+/-0.27 mg/dL (P<0 .0001). Baseline levels of oxidized LDL predicted cardiac transplant vascul opathy (chi(2)=16, P<0.0001) independent: of pretransplant: ischemic cardio myopathy, time after transplantation, age, and serum levels of LDL and high density lipoprotein cholesterol, The development of transplant CAD was ass ociated with a further increase of plasma levels of oxidized LDL (chi(2)=14 , P=0.0002). Oxidized LDL is a prognostic marker of transplant CAD.