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(Stroke. 1999;30:2541.)
© 1999 American Heart Association, Inc.

Original Contributions

Autoantibodies Against Oxidatively Modified LDL Do Not Constitute a Risk Factor for Stroke

A Nested Case-Control Study

Ejaz Ahmed, MD; Jasmina Trifunovic, MSc; Birgitta Stegmayr, MD, PhD; Göran Hallmans, MD, PhD Ann Kari Lefvert, MD, PhD

From the Immunological Research Unit (E.A., J.T., A.K.L.), Karolinska Institutet, Stockholm, Sweden, and the Department of Public Health and Clinical Medicine (B.S., G.H.), Umeå University Hospital, Umeå, Sweden.

Correspondence to Ann Kari Lefvert, MD, PhD, Immunological Research Unit, CMM L8:03, Karolinska Hospital, 171 76 Stockholm, Sweden. E-mail Ann.Kari.Lefvert{at}cmm.ki.se

Background and Purpose—Autoantibodies against oxidatively modified LDL have been shown to be associated with atherosclerosis. Their possible pathogenic role is not yet fully understood, and earlier published data are inconsistent. In this prospective study, we have investigated the association of these antibodies with future stroke.

Methods—A prospective case-control study in which 44 725 men and women from the World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) project and the Västerbotten Intervention Program (VIP) were enrolled and followed from January 1, 1985, to August 31, 1996. One hundred nineteen cases of stroke (male 75, female 44) were noted and compared with 233 age- and sex-matched controls from the same population. Antibodies against oxidatively modified LDL (copper-oxidized LDL and malonaldehyde [MDA]-LDL) were analyzed by ELISA.

Results—There was no difference in the levels or in the prevalence of IgG, IgA, and IgM autoantibodies against copper-oxidized LDL or MDA-LDL between patients and controls. Risk ratios for these antibodies, when adjusted for diabetes mellitus, hypertension, and smoking habits, did not confer a risk of stroke. Serum triglycerides (1.7 versus 1.4 mmol/L, P=0.01), fasting blood sugar, and systolic and diastolic blood pressures were significantly higher in the patient group than in the control group, as was the prevalence of hypertension (51.8% versus 27.4%, P<0.0001) and diabetes mellitus (9.6% versus 0.8%, P<0.001).

Conclusions—Autoantibodies against oxidatively modified LDL do not constitute a risk factor for stroke in an adult population.

Key Words: autoantibodies • cerebrovascular disorders • epidemiology • lipoproteins, LDL • oxidants

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