Letter Regarding Article by Tsimikas et al, “High-Dose Atorvastatin Reduces Total Plasma Levels of Oxidized Phospholipids and Immune Complexes Present on Apolipoprotein B-100 in Patients With Acute Coronary Syndromes in the MIRACL Trial”

Radboud University Medical Centre (Radboudumc), Nymegen, Gelderland, Netherlands
Circulation (Impact Factor: 14.43). 06/2005; 111(18):e284-5; author reply e284-5. DOI: 10.1161/01.CIR.0000164264.00913.6D
Source: PubMed


predominantly associated with Lp(a), 2 the increased OxPL/apoB ratio could be explained by the shift in the Lp(a)/LDL ratio. Similarly, in the placebo-treated group the decreased OxPL/apoB ratio results from a decrease in Lp(a) relative to LDL. It is therefore unlikely that the OxPL/apoB ratio is a surrogate marker of net removal of OxPL from the vessel wall. Moreover, the observed 30% decrease in total plasma apoB-OxPL also argues against an increased net efflux of OxPL from the vessel wall. Recently, using the OxLDL assay from Mercodia in which an oxidation epitope associated with apoB is detected with mono- clonal antibody 4E6, we found that atorvastatin (80 mg/d) and simvastatin (40 mg/d) reduced total plasma Ox-apoB (43% and 35%, respectively) in patients with familial hypercholesterol- emia from the ASAP study.3 Interestingly, we observed no change in the Ox-apoB/apoB ratio when we used the noncom- petitive version of the kit, in which the immobilized antibody captures Ox-apoB from the sample. We did, however, observe a small increase in the Ox-apoB/apoB ratio (18% for atorvastatin, 13% for simvastatin) when we used the competitive version, which unlike the noncompetitive version is sensitive to the number of oxidation epitopes associated with apoB. In addition, the increase in Ox-apoB/apoB ratio can be explained by an increase in Lp(a) relative to LDL. To further address this question, measurements of OxLDL with E06 and 4E6 in well- designed assays (eg, in isolated Lp(a) particles) at different time points after the start of statin treatment are required.

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Available from: Anton F H Stalenhoef, Sep 30, 2015
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