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

Although 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. Forty-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 7months 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 57months until the onset of the next coronary event. In the diabetic patients, the mean MDA-LDL level was significantly higher in those with ISR than in those without ISR (151+/−61 vs. 90+/−26U/l, p=0.010). A baseline MDA-LDL value of 110U/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 ≥110U/l correlated significantly with a higher prevalence of cardiac events than MDA-LDL