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)/β₂-glycoprotein I (β2GPI) complexes have been implicated in atherogenesis. oxLDL/β2GPI 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/β2GPI (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/β2GPI (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/β2GPI (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/β2GPI 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/β2GPI complexes are associated with severity of CAD and a 3.5-fold increased risk for adverse outcomes.