Increased serum malondialdehyde-modified low-density lipoprotein and coronary angiographic progression after drug-eluting stent implantation in patients with stable angina

概要

Cardiac events can occur after drug-eluting stent (DES) implantation due to coronary plaque progression at non-stented sites. Malondialdehyde-modified low-density lipoprotein (MDA-LDL) is suggested to be an atherogenic marker. This study investigated the relationship between serum MDA-LDL and angiographic progression after DES implantation. In total, 207 patients were retrospectively analyzed who underwent percutaneous coronary intervention (PCI) using DES and follow-up coronary angiography. MDA-LDL was serially measured before PCI and at follow-up. Persistent high MDA-LDL was defined as MDA-LDL level more than the median value both before PCI and at follow-up. Angiographic progression was assessed by serial analysis of quantitative coronary angiography. Angiographic progression occurred in 35 patients (16.9%). MDA-LDL before PCI was significantly higher in the progression group than the non-progression group in all patients (143.4 ± 35.8 U/L vs. 103.0 ± 33.5 U/L, P<0.001) and in patients with controlled LDL-cholesterol (LDL-C <100 mg/dL both before PCI and at follow-up) (121.8 ± 32.7 U/L vs. 84.9 ± 24.9 U/L, P<0.001). There were positive correlations between % diameter stenosis changes and serum MDA-LDL before PCI in all patients (r = 0.33, p<0.01) and those with controlled LDL- C (r = 0.23, p=0.04). In multivariate logistic regression analysis, persistent high MDA- LDL was an independent predictor of plaque progression. Increased serum MDA-LDL was associated with angiographic progression after DES implantation.