Impact of electronegative low-density lipoprotein on angiographic coronary atherosclerotic burden

Objective: Low density lipoproteins (LDL) with an electronegative charge [LDL()] may cause endothelial injury. We assessed the association between serum LDL() levels and coronary artery disease (CAD) severity. Methods:We prospectively enrolled patients with CAD angiographic evidence [stable angina (SA) or non- ST-elevation-acute coronary syndrome (NSTE-ACS)], or with normal coronary arteries (NCA). Baseline LDL() serum levels were measured in all patients. Angiographic CAD extent was assessed by using the Bogaty extent index, while CAD severity by evaluating the presence of multi-vessel disease. Results: Forty-seven patients (age 61 9 years, male sex 60%) were enrolled (17 SA, 15 NSTE-ACS and 15 NCA patients). LDL() levels were significantly higher in SA [21% (18e34) p ¼ 0.0001] and NSTE-ACS [22% (18e28), p ¼ 0.0001] as compared to NCA [6% (5e8)], without significant differences between SA and NSTE-ACS (p ¼ 0.92). Multi-vessel disease patients had higher LDL() levels as compared to single-vessel disease patients (p ¼ 0.002) but similar total LDL levels (p ¼ 0.66). LDL() significantly correlated with extent index (r ¼ 0.38, p ¼ 0.03), while total LDL did not (p ¼ 0.24). Conclusion: LDL() serum levels are associated with CAD angiographic severity and extent. This exploratory analysis should prime further larger studies in order to assess LDL() proatherogenic role.