Malondialdehyde-Modified Low-Density Lipoprotein Is a Useful Marker to Identify Patients With Vulnerable Plaque

Tajika, Kenichiro; Okamatsu, Kentaro; Takano, Masamichi; Inami, Shigenobu; Yamamoto, Masanori; Murakami, Daisuke; Kobayashi, Nobuaki; Ohba, Takayoshi; Hata, Noritake; Seino, Yoshihiko; Mizuno, Kyoichi

doi:10.1253/circj.cj-12-0183

Cited by 26 publications

(18 citation statements)

References 24 publications

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“…It has been shown that the plasma concentration of MDA-LDL is increased in patients with unstable carotid artery plaques [21]. In the present study, this combination tablet decreased MDA-LDL, which suggests the possibility that this medication might directly intervene in many processes of atherosclerosis.…”

Section: Discussionsupporting

confidence: 62%

Effect of single tablet of fixed-dose amlodipine and atorvastatin on blood pressure/lipid control, oxidative stress, and medication adherence in type 2 diabetic patients

Tanaka

Nishimura

et al. 2014

Diabetol Metab Syndr

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BackgroundOxidized low-density lipoprotein (LDL) plays central roles in the formation and progression of atherosclerotic lesions. Malondialdehyde (MDA)-modified LDL (MDA-LDL) is speculated to be generated as a result of oxidative stress in the human body. Because both amlodipine and atorvastatin have been reported to reduce oxidative stress, it is expected that both drugs would have a favorable influence to reduce oxidative stress.ObjectiveThe objective of this study was to investigate the effects of a single pill of amlodipine (5 mg)/atorvastatin (10 mg) on oxidative stress, blood pressure/lipid control and adherence to medication in patients with type 2 diabetes.MethodsThis combination tablet was administered to 29 patients (16 male), and MDA-LDL, blood pressure, lipid profile, renal/liver function, CPK, hs-CRP, adiponectin, BNP, and HbA1c were measured at baseline, 6, and 12 months, and baPWV and mean IMT were measured at baseline and 12 months. Medication adherence was examined using a questionnaire at 6 months.ResultsMDA-LDL was decreased significantly. LDL-C, TG, and Cr were significantly decreased at 6 and 12 months compared with baseline. eGFR was increased at 6 months, and urinary albumin/creatinine ratio was decreased at 12 months. BNP was decreased at 6 and 12 months, and adiponectin was increased at 12 months. Both mean IMT and baPWV were significantly decreased. The results of the questionnaire showed that 93% of patients were satisfied with this medication. No severe adverse event was observed.ConclusionThis combination tablet controlled both hypertension and dyslipidemia well in type 2 diabetic patients. The deceases in mean IMT and baPWV might suggest the improvement of atherosclerosis by this medication, which could be caused by the reduction of oxidative stress measured by MDA-LDL. In addition, this medication is expected to improve medication adherence.

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Section: Discussionsupporting

confidence: 62%

Effect of single tablet of fixed-dose amlodipine and atorvastatin on blood pressure/lipid control, oxidative stress, and medication adherence in type 2 diabetic patients

Tanaka

Nishimura

et al. 2014

Diabetol Metab Syndr

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“…SOD3 was the most powerful antioxidant enzyme that defended the ischemic myocardium by inhibiting reactive oxygen species. Further researches may lead to a novel antioxidant agent able either to increase SOD3 levels or to decrease MDA levels for myocardial infarction and chronic heart failure [18–22]. PECGGp increased the levels of NO and eNOS in cardiac tissue of infarcted myocardium and restored left ventricular ejection fraction, indicating key protective roles of NO and eNOS in myocardial infarction and heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…The studies suggested MDA concentrations were associated with thin-cap fibroatheroma, complex atherosclerotic plaque, and atherosclerotic plaque instability and they are the main cause of myocardial infarction. Anti-MDA could be useful for developing potential antiatherosclerosis vaccine [18]. …”

Section: Introductionmentioning

confidence: 99%

Unbalanced Oxidant‐Antioxidant Status: A Potential Therapeutic Target for Coronary Chronic Total Occlusion in Very Old Patients

Zhang

et al. 2016

Oxidative Medicine and Cellular Longevity

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Unbalanced oxidant and antioxidant status played an important role in myocardial infarction. The present study was a clinical trial combined preclinically with targeted agent against cardiovascular injuries and ischemia in vivo model. We tried to confirm the association of unbalanced oxidant and antioxidant status with coronary chronic total occlusion (CTO) in 399 very old patients (80~89 years) and investigated the potential therapeutic value of purified polysaccharide from endothelium corneum gigeriae galli (PECGGp). We analyzed levels of circulating superoxide dismutase 3 (SOD3), nitric oxide (NO), endothelial nitric oxide synthase (eNOS), and malondialdehyde (MDA) in very old patients with coronary CTO. Levels of SOD3, NO, eNOS, and MDA in the cardiac tissue were measured in myocardial infarction rats. Levels of SOD3, eNOS, and NO were lowered (p < 0.001) and levels of MDA were increased (p < 0.001). PECGGp treatment increased levels of SOD3, eNOS, and NO (p < 0.01) in cardiac tissue, while decreasing levels of MDA (p < 0.01). PECGGp may suppress unbalanced oxidant and antioxidant status in infarcted myocardium by inhibiting levels of MDA and elevating NO, eNOS, and SOD3 levels. PECGGp could be considered as a potential therapeutic agent for coronary CTO in very old patients.

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“…Their system can consistently measure yellow plaque color independent of such conditions as light intensity, the distance from the lens of angioscope to the objective, and the angle of the angioscope to the region of interest, after proper adjustments for brightness (L * value is within 42) and are strongly correlated with the thin cap fibroatheroma determined by Virtual Histology-IVUS. 43) The plaques of b * value >23 are associated with elevated malondialdehyde-modified low-density lipoprotein levels 44) , which has been reported to be detected in the plasma of patients with ACS.…”

Section: ) Semi-quantitative Evaluationmentioning

confidence: 98%

What Does the Yellow Color of Angioscopy Mean? Why Yellow Plaque Is Always Vulnerable?

Mizuno

Takano

2017

Angioscopy

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Angioscopy is the only imaging modality that can directly evaluate the color of plaques. Therefore, nothing is more important to angioscopy than color. Plaque is classified into yellow plaque and white plaque according to their color. Yellow plaque has been considered to be vulnerable and high risk for the acute coronary syndromes, especially high-intense yellow plaque. Beta carotene is lipotorophic binding to lipid and coexisting with lipids in human atherosclerotic lesions and produces the yellow color of atherosclerotic plaque. Yellow plaque has several kinds of histopathology, such as a thin fibrous cap with lipid core, superficial or diffuse lipid deposition (cholesterol and cholesterol ester) with or without macrophage-foam cells and calcified plate. Therefore, all yellow plaques might not be vulnerable. Some pharmacological intervention and trans-catheter therapy decreased the intensity of yellow color. As angioscopic interpretation of color is usually subjective, objective computerized colorimetric evaluation is desirable.

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Malondialdehyde-Modified Low-Density Lipoprotein Is a Useful Marker to Identify Patients With Vulnerable Plaque

Cited by 26 publications

References 24 publications

Effect of single tablet of fixed-dose amlodipine and atorvastatin on blood pressure/lipid control, oxidative stress, and medication adherence in type 2 diabetic patients

Effect of single tablet of fixed-dose amlodipine and atorvastatin on blood pressure/lipid control, oxidative stress, and medication adherence in type 2 diabetic patients

Unbalanced Oxidant‐Antioxidant Status: A Potential Therapeutic Target for Coronary Chronic Total Occlusion in Very Old Patients

What Does the Yellow Color of Angioscopy Mean? Why Yellow Plaque Is Always Vulnerable?

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