Background: Oxidative stress is a well-established contributor to the pathogenesis and progression of coronary artery disease (CAD). Biomarkers such as oxidized low-density lipoprotein (Ox-LDL) and malondialdehyde (MDA) provide insight into vascular oxidative burden. However, the influence of age on these markers across varying severities of CAD remains inadequately characterized.
Objective: To evaluate the levels of serum oxidized low-density lipoprotein (Ox-LDL) and malondialdehyde (MDA) across different age groups and their association with coronary artery disease (CAD) severity, as stratified by CAD-RADS classification.

 Methods: This cross-sectional study included 190  CAD patients aged >40 years, who were admitted to Teerthanker Mahaveer Hospital and underwent angiography. Patients were categorized into four age groups (41–50, 51–60, 61–70, and 71–80 years) and three CAD severity groups (mild, moderate, severe). Serum Ox-LDL and MDA levels were quantified using ELISA. One-way ANOVA was used for statistical analysis.

 Results: MDA levels showed a significant and progressive increase with advancing age (p < 0.001), while Ox-LDL levels exhibited a non-significant upward trend (p = 0.23). Both biomarkers were significantly elevated in patients with severe CAD compared to mild and moderate groups (p < 0.001). Post hoc analysis confirmed the most pronounced differences in biomarker levels between mild and severe CAD groups.

Conclusion: MDA exhibits a strong age-related rise in CAD patients, reflecting increased oxidative stress with advancing age in CAD patients. While Ox-LDL correlates more closely with disease severity than age, both markers together may serve as valuable tools for assessing oxidative burden and stratifying cardiovascular risk in elderly CAD populations.