Oxidative stress with its high rate of oxygen free radical (ROS) formation is a significant risk factor in atherogenesis, the clinical sequelae of which, myocardial infarction and stroke, still constitute more than 50% of all deaths in westernized countries. Therefore, careful assessment of accident risk in diagnostics as well as steady supervision of cardio-cerebro-vascular parameters in therapy verification are imperative requirements. Patients with metabolic syndrome are specially endangered as a result of their high ROS burden with additional inclination to Diabetes mellitus (figure). The augmented formation of oxidized LDL (oxLDL) effective apoptotically and cytotoxically as well as of the even more dangerous glycated oxidized LDL (glyc-oxLDL) are rated as decisive risk factors for cardio-cerebro-vascular diseases according to present opinion. Thus, we measured in several clinical studies with cardiovascular high-risk patients - both in diagnostics and therapy - blood lipids, cytokine balance and enzyme activities. Besides nanoplaque formation and size, a wide spectrum of parameters and biomarkers of oxidative stress, plaque stability and progression, inflammation, lipid composition including Lp(a) and second messengers was measured. As markers of oxidative stress, the isoprostane 8-iso-PGF_2a, the ratio oxLDL/LDL and the activities of superoxide dismutase and glutathione peroxidase were determined. The inflammatory status was characterized by highly-sensitive CRP, myeloperoxidase, tumor necrosis factor a and transforming growth factor b₁. Furthermore, matrix metalloproteinase-9 was measured as a relatively new marker to assess plaque stability. The biomarkers selected allow a pattern analysis and are suited to provide a comprehensive risk profile assessment for the prevention of atherosclerosis.

Figure 1