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)/beta(2)-glycoprotein I (beta 2GPI) complexes have been implicated in atherogenesis. oxLDL/beta 2GPI 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 oxLDL/beta 2GPI (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 oxLDL/beta 2GPI (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 oxLDL/beta 2GPI (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 oxLDL/beta 2GPI 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 oxLDL/beta 2GPI complexes are associated with severity of CAD and a 3.5-fold increased risk for adverse outcomes.