Antibodies to Oxidized LDL as Predictors of Morbidity and Mortality in Patients With Chronic Heart Failure
Received 22 November 2008; received in revised form 4 May 2009; accepted 7 May 2009. published online 06 July 2009.
Abstract
Background
Oxidative stress appears to play a significant role in the pathogenesis of heart failure (HF). Antibodies to oxidized low-density lipoprotein (Ox LDL Abs) reflect an immune response to LDL over a prolonged period and may thus represent oxidative stress over an extended time. Ox LDL Abs have been shown to correlate with clinical control in HF patients. We evaluated the predictive power of Ox LDL Abs on the outcome in patients with HF.
Methods and Results
Baseline levels of Ox LDL Abs were determined by enzyme-linked immunosorbent assay in 284 consecutive outpatients with severe chronic HF who were being treated in the cardiology services of our medical center. Their mean New York Heart Association (NYHA) Class was 2.8. The mean follow-up for the group was 3.7 years, during which 107 (37%) died. The mean time from symptom onset to first hospital admission from HF was 25.8 months. Ox LDL Abs were found to predict morbidity and mortality as evaluated by a Cox multivariate regression analysis with a hazard ration of 1.013 (P < .013), whereas N-terminal pro-B-type natriuretic peptide (NT pro-BNP) levels achieved a HR of 1.028 (P < .099).
Conclusions
Ox LDL Abs level maybe a useful parameter for monitoring and planning better management of patients with HF. It was superior to pro-BNP as a predictor of clinical course as expressed by time to hospitalization.
1Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
2Internal Medicine “C”, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
3Lipid Unit, Tel Aviv, Israel, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Correspondence to: Gideon Charach, MD, The Department of Cardiology, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv, 64239 Israel. Tel: +972-524-266851; Fax: +972-3-6974990.
ABSTRACT