Super Clinic(Koishikawa International Clinic)

Arteriosclerosis test “LOX-index” Determination of risk of future stroke and myocardial infarction


This article was supervised by:M.D., Director of Koishikawa International Clinic

Dr. Akihiko Kawai

Graduated from Hokkaido University School of Medicine. Practiced and served in heart transplantation at the University of Pittsburgh, USA. After returning to Japan, Dr, Kawai organized a heart transplant team as an associate professor at Tokyo Women's Medical University. After practicing at Tokyo Takanawa Hospital, he opened Koishikawa International Clinic in 2017. Dr. Kawai has a great deal of experience in medical care for international patients.

Arteriosclerosis risk assessment test developed in Japan

LOX-index is a test developed by the Japanese manufacturer “Primedica Corporation” to evaluate the risk of developing cerebral and myocardial infarctions based on the progression of arteriosclerosis. Cerebral and myocardial infarctions are mainly caused by arteriosclerosis and often develop without warning, resulting in death. To prevent this from happening, it is important to know the risk of arteriosclerosis on a regular basis and take measures if the risk is high.

How do stroke and myocardial infarction occur?

Atherosclerosis occurs when bad cholesterol (LDL cholesterol) and lipids accumulate on the inner walls of arteries, forming bumps called “plaques” that narrow and harden blood vessels. When the plaque breaks, a blood clot called a thrombus forms, which can cause a “cerebral infarction” if it clogs in the brain or a “myocardial infarction” if it clogs in the heart.

Indicators to be examined in the “LOX-index”

Oxidized denatured LDL for cholesterol quality

When LDL cholesterol is oxidized in the body and becomes oxidized cholesterol, immune cells called macrophages, which normally clean cholesterol from the walls of arteries, are unable to process oxidized cholesterol and turn into cholesterol-filled foam cells. When these accumulates in the arterial intima, they form fatty streaks (atheroma), the initial stage of atherosclerosis. The LOX-index examines the degree of oxidation or degeneration of this LDL cholesterol. The worst substance that oxidizes LDL cholesterol is said to be nicotine.

LOX-1 to examine vascular wall condition

The receptor for uptake of oxidized denatured LDL is LOX-1. The activation of LOX-1 increases the inflammatory response of the vascular wall, leading to impairment of vascular endothelial function. This reduces vasodilation and increases the risk of hypertension and cardiovascular disease. The activity level of this LOX-1 is examined.

What if the results show that the risk is high?

The “LOX-index” evaluates the risk of atherosclerosis by multiplying oxidized denatured LDL by the LOX-1 value.

If a high-risk result is obtained, the Koishikawa International Clinic will provide advice and prescriptions for medications to reduce the risk. If oxidized denatured LDL levels are high, the doctor can provide support through consultation, such as dietary guidance to lower the LDL itself or reduce LDL oxidation, prescriptions for medications to lower LDL cholestrol levels, and diabetes control.

If LOX-1 levels are high, the physician can provide support through consultation, such as exercise guidance aimed at improving vascular function and other vascular health benefits, as well as prescribing antioxidant medications and supplements.

LOX-index” is available at Koishikawa International Clinic

Koishikawa International Clinic offers “LOX-index” testing by blood sampling. Please contact EAJ if a patient wishes to have the test. Results will be available in approximately one week, and if a patient receives an assessment of high risk, he/she can seek a separate consultation to receive support for countermeasures and remediation. The consultation can be provided online.