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The failure of antioxidant vitamins to influence clinical outcomes may have many explanations, including the inability of vitamin E to prevent the formation of these oxidized phospholipids and other lipid oxidation products of the myeloperoxidase pathway.

HDL, apoA-I, and apoA-I mimetic peptides have been shown to prevent LDL oxidation in cell-free systems (1, 13, 14) and in the artery wall coculture studies of Navab et al. (Heinecke, J. W. 2003. Oxidative stress: new approaches to diagnosis and prognosis in atherosclerosis. Am. J. Cardiol. 91: 12A–16A )