Investigation of MDA-LDL (malondialdehyde-modified low-density lipoprotein) as a prognostic marker for coronary artery disease in patients with type 2 diabetes mellitus

• ・We examined elevated MDA-LDL as a prognostic factor for coronary artery disease.
• ・Relationships between the circulating MDA-LDL level and in-stent restenosis.
• ・Circulating MDA-LDL is a useful prognostic marker for future cardiac event in diabetic patients with CAD.

BackgroundAlthough increased circulating levels of malondialdehyde-modified low-density lipoprotein (MDA-LDL) are associated with coronary artery disease (CAD), there is no direct evidence that increased MDA-LDL is a prognostic factor for CAD.MethodsForty-two patients (20 diabetic and 22 non-diabetic patients) who underwent percutaneous coronary intervention (PCI) were enrolled, and their baseline MDA-LDL levels were determined by immunoassay. Follow-up coronary angiography was performed at 2 to 7 months post-PCI. The patients were then divided into 2 groups, with in-stent restenosis (ISR) (n = 13) and without ISR (n = 29), and the baseline MDA-LDL levels were compared. We also studied 34 diabetics with CAD for up to 57 months until the onset of the next coronary event.ResultsIn the diabetic patients, the mean MDA-LDL level was significantly higher in those with ISR than in those without ISR (151 +/− 61 vs. 90 +/− 26 U/l, p = 0.010). A baseline MDA-LDL value of 110 U/l for differentiating between diabetics with and without ISR was defined as the cut-off value. Kaplan–Meier analysis demonstrated that a circulating MDA-LDL of ≥ 110 U/l correlated significantly with a higher prevalence of cardiac events than MDA-LDL < 110 U/l (p = 0.032).ConclusionsCirculating MDA-LDL is a useful prognostic marker for future cardiac event in diabetic patients with CAD.