Circulating oxidized LDL is a useful marker for identifying patients with coronary artery disease

Our aim was to determine the usefulness of circulating oxidized low density lipoprotein (LDL) in the identification of patients with coronary artery d isease (CAD). A total of 304 subjects were studied: 178 patients with angio graphically proven CAD and 126 age-matched subjects without clinical eviden ce of cardiovascular disease. The Global Risk Assessment Score (GRAS) was c alculated on the basis of age, total and high density lipoprotein cholester ol, blood pressure, diabetes mellitus, and smoking. Levels of circulating o xidized LDL were measured in a monoclonal antibody 4E6-based competition EL ISA. Compared with control subjects, CAD patients had higher levels of circ ulating oxidized LDL (P<0.001) and a higher GRAS (P<0.001). The sensitivity for CAD was 76% for circulating oxidized LDL (55% for men and 81% for wome n) compared with 20% (24% for men and 12% for women) for GRAS, with a speci ficity of 90%. Logistic regression analysis revealed that the predictive va lue of oxidized LDL was additive to that of GRAS (P<0.001). Ninety-four per cent of the subjects with high (exceeding the 90th percentile of distributi on in control subjects) circulating oxidized LDL and high GRAS had CAD (94% of the men and 100% of the women). Thus, circulating oxidized LDL is a sen sitive marker of CAD. Addition of oxidized LDL to the established risk fact ors may improve cardiovascular risk prediction.