***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aims We aim ed to determine whether the levels of total serum IgM and IgG , together with specific antibodies against malondialdehyde-conjugated low-density lipoprotein ( MDA-LDL ) , can improve cardiovascular risk discrimination . Methods and Results The Anglo-Sc and inavian Cardiac Outcomes Trial ( ASCOT ) r and omized 9098 patients in the UK and Irel and into the Blood Pressure-Lowering Arm . 485 patients that had cardiovascular ( CV ) events over 5.5 years were age and sex matched with 1367 controls . Higher baseline total serum IgG , and to a lesser extent IgM , were associated with decreased risk of CV events ( IgG odds ratio ( OR ) per one st and ard deviation ( SD ) 0.80 [ 95 % confidence interval , CI 0.72,0.89 ] , p < 0.0001 ; IgM 0.83[0.75,0.93 ] , p = 0.001 ) , and particularly events due to coronary heart disease ( CHD ) ( IgG OR 0.66 ( 0.57,0.76 ) ; p < 0.0001 , IgM OR 0.81 ( 0.71,0.93 ) ; p = 0.002 ) . The association persisted after adjustment for a basic model with variables in the Framingham Risk Score ( FRS ) as well as following inclusion of C-reactive protein ( CRP ) and N-terminal pro-B-type natriuretic peptide ( NtProBNP ) . IgG and IgM antibodies against MDA-LDL were also associated with CV events but their significance was lost following adjustment for total serum IgG and IgM respectively . The area under the receiver operator curve for CV events was improved from the basic risk model when adding in total serum IgG , and there was improvement in continuous and categorical net reclassification ( 17.6 % and 7.5 % respectively ) as well as in the integrated discrimination index . Conclusion High total serum IgG levels are an independent predictor of freedom from adverse cardiovascular events , particularly those attributed to CHD , in patients with hypertension Objective — Previous smaller studies have indicated inverse associations between autoantibodies to oxidized low-density lipoprotein epitopes , and cardiovascular disease . The present study investigated associations between autoantibodies against the apolipoprotein B-100 peptides p45 and p210 , respectively , and risk of incident cardiovascular disease in a large population -based cohort . Approach and Results — Apolipoprotein B-100 autoantibodies were analyzed by ELISA in a prospect i ve study , including 5393 individuals ( aged 46–68 years ) belonging to the cardiovascular arm of the Malmö Diet and Cancer study with a follow-up time of > 15 years . Subjects that suffered an acute coronary event during follow-up ( n=382 ) had lower levels at baseline of IgM autoantibodies recognizing the native and malondialdehyde-modified apolipoprotein B-100 peptides p45 and p210 and also lower IgG levels recognizing native p210 , whereas no association was found with risk for stroke ( n=317 ) . Subjects in the highest compared with lowest tertile of IgM-p45MDA ( hazard ratio [ 95 % confidence interval ] : 0.72 [ 0.55 , 0.94 ] ; P=0.017 ) and IgG-p210native ( hazard ratio [ 95 % confidence interval ] : 0.73 [ 0.56 , 0.97 ] ; P=0.029 ) had lower risk for incident coronary events after adjustment for cardiovascular risk factors in Cox proportional hazard regression models . Moreover , subjects with high levels of IgG-p210native were less likely to have carotid plaques as assessed by ultrasonography at baseline ( odds ratio=0.81 , 95 % confidence interval 0.70–0.95 , P=0.008 after adjustment for risk factors ) . Conclusions — This large prospect i ve study demonstrates that subjects with high levels of apolipoprotein B-100 autoantibodies have a lower risk of coronary events supporting a protective role of these autoantibodies in cardiovascular disease BACKGROUND Biomarkers to predict recurrent stroke and targets of therapy to prevent stroke are lacking . OBJECTIVES This study evaluated whether patients with prior cerebrovascular events and elevated levels of oxidized phospholipids on apolipoprotein B-100 ( OxPL-apoB ) , but without prior coronary artery disease ( CAD ) , are at risk for recurrent stroke and CAD events following high-dose statin therapy . METHODS In the SPARCL ( Stroke Prevention by Aggressive Reduction in Cholesterol Levels ) trial , OxPL-apoB levels were measured in 4,385 patients with stroke or transient ischemic attack at baseline and in 3,106 patients at 5 years following r and omization to placebo or 80 mg atorvastatin .  The primary endpoint was the time from r and omization to a second nonfatal or fatal stroke . Secondary endpoints included first major coronary events and any cardiovascular event . RESULTS Patients with recurrent stroke had higher baseline median OxPL-apoB levels than patients without ( 15.5 nmol/l vs. 11.6 nmol/l ; p < 0.0001 ) . After multivariable adjustment , elevated baseline OxPL-apoB predicted recurrent stroke ( hazard ratio [ HR ] : 4.3 ; p < 0.0001 ) , first major coronary events ( HR : 4.0 ; p < 0.0001 ) , and any cardiovascular event ( HR : 4.4 ; p < 0.0001 ) . These comparisons for any endpoint did not differ by treatment , shown as a nonsignificant interaction test . The net reclassification improvement , integrated discrimination improvement , and area under the receiver-operating characteristic curve ( AUC ) were all significantly improved by adding OxPL-apoB to the models , with ΔAUC + 0.0505 ( p < 0.0001 ) for recurrent stroke , ΔAUC + 0.0409 ( p < 0.0001 ) for first major coronary event , and ΔAUC + 0.0791 ( p < 0.0001 ) for any cardiovascular event . CONCLUSIONS Elevated OxPL-apoB levels predicted recurrent stroke and first major coronary events in patients with prior stroke or transient ischemic attack . The lack of statin-OxPL-apoB treatment interaction suggested that OxPLs might be statin-independent therapeutic targets to reduce risk of cardiovascular events . ( Lipitor in the Prevention of Stroke , for Patients Who Have Had a Previous Stroke [ SPARCL ] ; NCT00147602 ) AIMS Antibodies to oxidized low-density lipoproteins ( oxLDLAbs ) are detectable in the serum of patients with and without atherosclerosis , but it is unclear if they play a pathogenic or a protective role in atherogenesis or if they are simply a marker of atherosclerosis . Therefore , in a prospect i ve cohort study we investigated if oxLDLAbs titer predicts cardiovascular ( CV ) events in high-risk coronary artery disease patients . METHODS AND RESULTS The titer of IgG antibodies to malondialdehyde modified oxidized low-density lipoproteins was measured in 748 r and omly selected patients of the GENICA study who underwent coronary angiography and assessment of incident CV events at follow-up . Patients were classified by oxLDLAbs into a low and a high titer group , corresponding to the first three and the last quartile , respectively . Cardiovascular event-free survival was compared between oxLDLAbs groups by Kaplan-Meier and multivariate technique including propensity score matching analysis . During long-term follow-up ( median 7.2 years ) CV deaths were observed in 65 patients ( 11.6 % ) , more commonly in the high than in the low oxLDLAbs group ( patients free from CV death 83.1 % vs. 89 % respectively , p=0.025 ) . The incidence of CV events was also higher in the former than in latter ( event-free survival 69.2 % vs. 77.7 % respectively , p=0.030 ) . CONCLUSIONS An oxLDLAbs titer above the 75th percentile is a marker of LDL oxidation which predicts a worse CV prognosis at long term follow-up in high-risk Caucasian patients referred for coronary angiography BACKGROUND The relation between measures of oxidation of lipid particles and cardiovascular disease has not been extensively investigated prospect ively on a population basis . METHODS A community cohort of 1192 men and 1427 women with measures of IgG antibodies to oxidized LDL were followed 8 years for the development of initial coronary heart disease ( CHD ) and cardiovascular disease ( CVD ) events . RESULTS Levels of IgG autoantibodies to a form of oxidized LDL were significantly associated with age in both sexes , positively with fibrinogen in men and negatively with HDL cholesterol in women . In sex-specific models that adjusted for age alone or those that adjusted for age , cholesterol , HDL cholesterol , smoking , and diabetes mellitus , there was no relation between level of antibodies to oxidized LDL and the development of CHD or CVD . CONCLUSION Autoantibodies to oxidized LDL were strongly related to age and were not related to incident CHD or CVD over 8 years of follow up Background Certain immunoglobulins ( Ig ) are proposed to have protective functions in atherosclerosis . Objectives We tested whether serum levels of IgG and IgM autoantibodies against malondialdehyde low density lipoprotein ( MDA-LDL ) are associated with clinical coronary heart disease ( CHD ) and unfavorable plaque characteristics . Methods NORDIL was a prospect i ve study investigating adverse cardiovascular outcomes in hypertensive patients . IBIS-3 analyzed lesions in a non-culprit coronary artery with < 50 % stenosis using radiofrequency intravascular ultrasound ( RF-IVUS ) and near-infrared spectroscopy ( NIRS ) . Imaging was repeated after a median of 386 days on rosuvastatin . Associations of antibodies with incident CHD and imaging parameters were assessed in the two sub- studies respectively . Findings From 10,881 NORDIL patients , 87 had serum sample d at baseline and developed CHD over 4.5 years , matched to 227 controls . Higher titers of IgM anti-MDA-LDL had a protective effect on adverse outcomes , with odds ratio 0.29 ( 0.11 , 0.76 ; p = 0.012 ; p = 0.016 for trend ) . Therefore , the effect was explored at the lesional level in IBIS-3 . 143 patients had blood sample s and RF-IVUS measurements available , and NIRS was performed in 90 of these . At baseline , IgM anti-MDA-LDL levels had a strong independent inverse relationship with lesional necrotic core volume ( p = 0.027 ) and percentage of plaque occupied by necrotic core ( p = 0.011 ) , as well as lipid core burden index ( p = 0.024 ) in the worst 4 mm segment . Interpretation Our study supports the hypothesis that lower circulating levels of IgM anti-MDA-LDL are associated with clinical CHD development , and for the first time relates these findings to atherosclerotic plaque characteristics that are linked to vulnerability AIMS Acute coronary syndromes ( ACS ) are mostly caused by plaque rupture . This study aims to investigate the prognostic value of in vivo detection of high-risk coronary plaques by intravascular ultrasound ( IVUS ) in patients undergoing coronary angiography .  METHODS AND RESULTS Between November 2008 and January 2011 , IVUS of a non-culprit coronary artery was performed in 581 patients who underwent coronary angiography for ACS ( n = 318 ) or stable angina ( n = 263 ) . Primary endpoint was major adverse cardiac events ( MACEs ) defined as mortality , ACS , or unplanned coronary revascularization . Culprit lesion-related events were not counted . Cumulative Kaplan-Meier incidence of 1-year MACE was 7.8 % . The presence of IVUS virtual histology-derived thin-cap fibroatheroma ( TCFA ) lesions ( present 10.8 % vs. absent 5.6 % ; adjusted HR : 1.98 , 95 % CI : 1.09 - 3.60 ; P = 0.026 ) and lesions with a plaque burden of ≥70 % ( present 16.2 % vs. absent 5.5 % ; adjusted HR : 2.90 , 95 % CI : 1.60 - 5.25 ; P < 0.001 ) were independently associated with a higher MACE rate . Thin-cap fibroatheroma lesions were also independently associated with the composite of death or ACS only ( present 7.5 % vs. absent 3.0 % ; adjusted HR : 2.51 , 95 % CI : 1.15 
    Output:
    
IgM anti-oxLDL antibodies were found to indicate protection from more severe CAD and possibly cardiovascular events , whilst the relationship with IgG is more complex and difficult to eluci date , with studies reporting divergent results .
In this systematic review , there is evidence that suggests a relationship between anti-oxLDL antibodies and CAD , especially for the IgM subclass .