Impact of electronegative low-density lipoprotein on angiographic coronary atherosclerotic burden

ObjectiveLow density lipoproteins (LDL) with an electronegative charge [LDL(−)] may cause endothelial injury. We assessed the association between serum LDL(−) levels and coronary artery disease (CAD) severity.MethodsWe prospectively enrolled patients with CAD angiographic evidence [stable angina (SA) or non-ST-elevation-acute coronary syndrome (NSTE-ACS)], or with normal coronary arteries (NCA). Baseline LDL(−) serum levels were measured in all patients. Angiographic CAD extent was assessed by using the Bogaty extent index, while CAD severity by evaluating the presence of multi-vessel disease.ResultsForty-seven patients (age 61 ± 9 years, male sex 60%) were enrolled (17 SA, 15 NSTE-ACS and 15 NCA patients). LDL(−) levels were significantly higher in SA [21% (18-34) p = 0.0001] and NSTE-ACS [22% (18-28), p = 0.0001] as compared to NCA [6% (5-8)], without significant differences between SA and NSTE-ACS (p = 0.92). Multi-vessel disease patients had higher LDL(−) levels as compared to single-vessel disease patients (p = 0.002) but similar total LDL levels (p = 0.66). LDL(−) significantly correlated with extent index (r = 0.38, p = 0.03), while total LDL did not (p = 0.24).ConclusionLDL(−) serum levels are associated with CAD angiographic severity and extent. This exploratory analysis should prime further larger studies in order to assess LDL(−) proatherogenic role.