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Coronary heart disease (CAD), as the leading cause of death from cardiovascular diseases worldwide, the association between its disease progression and the recurrence of ischemic events (IEs) as well as vascular injury (DBVs) has always been the core direction of clinical research. Recently, a cross-sectional study published by a team from the University of Guadalajara in Mexico in Healthcare (2025, 13, 1426) It provides a new basis for the value of oxidized low-density lipoprotein (OxLDL) in the clinical assessment of coronary heart disease - serum OxLDL levels are significantly positively correlated with the number of ischemic events and damaged blood vessels in patients with coronary heart disease, and are expected to become a key biomarker for judging the severity of the disease.

I. Research Conclusions

The level of OxLDL is directly related to the severity of coronary heart disease

This study included 51 Mexican patients diagnosed with coronary heart disease. Serum OxLDL levels were detected by ELISA, and stratified analysis was conducted in combination with the number of ischemic events and the number of damaged blood vessels. Three core findings were obtained:

The level of OxLDL increased significantly with the aggravation of the disease

Patients with ≥2 ischemic events and ≥2 damaged blood vessels Its OxLDL level (8,293.35 ng/mL [7,131.32-9,287.39]) was significantly higher than that of patients with only one ischemic event and one vessel damage (6,474.26 ng/mL [5,374.52-7,574.01]). The difference was statistically significant (p=0.029) .

OxLDL is clearly positively correlated with ischemic events and vascular injury

Linear regression analysis showed that the correlation coefficient R² between OxLDL levels and the number of ischemic events was 0.152 (B=0.142, p=0.005), and the correlation coefficient R² with the number of damaged blood vessels was 0.192 (B=0.196, p=0.020). Moreover, after adjusting for confounding factors such as age, gender, smoking and drinking habits, and drug treatment, the correlation still remained stable.

The critical value of OxLDL can predict high-risk populations

Taking the mean OxLDL of the study population (7358.82 ng/mL) as the critical value, patients with OxLDL≥7358.82 ng/mL had a 4.6 times increased risk of ≥2 ischemic events and ≥2 vessel damage (OR=4.667, 95% CI:) 1.341-16.239, p=0.012) [1], providing a quantitative standard for clinical risk stratification.

Ii. Mechanism Analysis

How does OxLDL promote the progression of coronary heart disease?

The research further confirmed the "dual role" of OxLDL in the process of atherosclerosis - it is both a "product" of oxidative stress and a "key driver" for disease deterioration. Its mechanism of action is mainly reflected in two aspects :

Promoting foam cell formation: OxLDL is phagocytosed by macrophages in the intima of blood vessels to form foam cells, laying the "foundation" for atherosclerotic plaques;

Activating inflammatory and thrombotic pathways: OxLDL induces the secretion of adhesion molecules and pro-inflammatory cytokines by vascular endothelium, accelerating plaque instability and ultimately leading to plaque rupture and thrombosis, resulting in recurrence of ischemic events and aggravation of vascular damage.

Iii. Clinical Value

OxLDL detection provides a new tool for the management of coronary heart disease

At present, the clinical assessment of coronary heart disease mostly relies on four lipid items (total cholesterol, LDL-C, HDL-C, and triglycerides). However, this study points out that even if patients receive statin treatment (such as atorvastatin) and LDL-C is controlled, OxLDL can still effectively identify high-risk populations. Its clinical value is mainly reflected in three aspects.

Supplement the deficiencies of traditional lipid profile tests

Traditional lipid indicators are difficult to accurately reflect the degree of vascular oxidative damage, while OxLDL can directly associate ischemic events with vascular damage, providing an additional assessment dimension for patients who "meet lipid standards but still have a risk of event recurrence".

Help stratify the severity of the disease

Clinically, patients requiring intensive intervention (such as increasing the dosage of antiplatelet drugs or adjusting lipid-lowering regimens) can be quickly identified, reducing missed diagnoses and overtreatment.

Promote individualized intervention

Traditional lipid indicators are difficult to accurately reflect the degree of vascular oxidative damage, while OxLDL can directly associate ischemic events with vascular damage, providing an additional assessment dimension for patients who "meet lipid standards but still have a risk of event recurrence".