The Relationships Between Serum Antibodies Against Oxidized Low-density Lippoprotein And Coronary Lesions As Well As Clinical Prognostics In Patients With ST-segment Elevation Acute Myocardial Infarction

Objective 1. To examine the association between serum autoantibodies against oxidized low-density lipoprotein IgM (ox-LDL-AbIgM) and coronary lesions in patients with ST-segment elevation acute myocardial infarction (STEMI). Patients who underwent elective coronary angiography (CAG) were divided into single-, double-and triple-vessel disease group according to the number of vessls with significant stenosis, and Gensini's score were calculated. Comprehend the level of ox-LDL-AbIgM among different vessel disease groups, and analyze the relation between ox-LDL-AbIgM and Gensini's score.2. To analyze the relations between ox-LDL-AbIgM and clinical factors, such as maleic dialdehyde (MDA), serum lipids and plasma glucose.3. To analyze the relations between ox-LDL-AbIgM and prognostic in STEMI patients.Methods 95 patients with STEMI who underwent elective coronary angiography (CAG) and PCI in the cardiology department of the second hosipital of Tianjin Medical Univisity from August 2008 to May 2009 were enrolled the study. Each case was recorded age, sex, renal function, hypertension, diabetes, ox-LDL-AbIgM, MDA, plasma glucose, serum lipids, white blood cell (WBC), body mass index (BMI) and Gensini's score were calculated. All patients were divided into single-, double-and triple-vessel lesion group according to the number of vessls with significant stenosis. All patients also were divided into LAD group and RCA group according to the infarct-related artery, and divided into cardiovascular events group and control group according to cardiovascular events, such as arrhythmias, heart failure, post-infarction angina pectories, cardiogenic shock and death.Result 1. There were significant differences in ox-LDL-AbIgM, MDA, WBC and uric acid (UA) level among different vessel disease groups (P<0.05). Spearman correlations showed that ox-LDL-AbIgM was not correlated with Gensini's score; 2. Ox-LDL-AbIgM was negatively and significantly correlated with MDA (r=-0.319, P <0.05), but was not correlated with other clinical factors (P>0.05).3. Compared to cardiovascular events group, the control group had higher level of ox-LDL-AbIgM (P <0.05). Logistic linear regression analysis showed that ox-LDL-AbIgM was a protection factor to patients with STEMI (OR=-0.588, P<0.05).Conclusion 1. The level of ox-LDL-AbIgM can reflects the severity of atherosclerosis in patients with STEMI.2. ox-LDL-AbIgM may paly a role in adjusting the oxidative stress to reduce LDL modificated to ox-LDL, and ruduce the coronary atherosclerosis area.3. ox-LDL-AbIgM may have a protective effect to the prognosis of patients with STEMI.