Oxidative Stress Markers in Young Patients with Acute Myocardial Infarction and Their Correlation with Cardiac Enzymes

Year 2021, , 73 - 80, 25.08.2021

Umut Karabulut , Dilay Karabulut , Cüneyt Kocaş , Ayşem Kaya Fahrettin Katkat Zerrin Yiğit

https://doi.org/10.26650/experimed.2021.926862

Abstract

Objective: The relationship between oxidative stress and acute myo-cardial infarction has been shown in studies. Total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) reflect the oxidative balance. The risk factors, clinical features, and prognosis of acute myocardial infarction (AMI) in young patients differ from older counterparts. This study aims to determine the oxidative stress in the young acute AMI patients and its' correlation with cardiac markers within 48 hours by the quantitative measurement of TAS, TOS, and OSI.

Material and Method: In this prospective, controlled study, we included 50 patients who were 45 years old or younger and di-agnosed with AMI, as well as 20 healthy individuals as the control group. TOS and TAS were measured from venous blood samples via the spectrophotometric method. The oxidative stress index was obtained from these parameters.

Results: Forty-five of totally 50 patients were male, and the mean age was (36±6.8). TOS and OSI values were found significantly higher than in the control group (p=0.002, p=0.005, respectively). TAS val-ues were found not to be different from the control group (p=0.46). A significant correlation was found between CK 0. hour (h.), and TOS 0. h., CK-MB 0. h., and TOS 0. h., CK 48. h. and OSI 48. h., CK-MB 48. h. and OSI 48. h., respectively (r=0.36, p=0.008), (r=0.46, p=0.001), (r=0.32, p=0.03), (r=0.36, p<0.01).

Conclusion: Oxidative stress increases in the early hours of AMI. The TOS and OSI values are correlated with cardiac markers at only some time points, and their prognostic values are limited in young AMI patients. TAS is not correlated with cardiac markers.

Keywords

Total antioxidant status, total oxidant status, oxidative stress index, myocardial infarction

Supporting Institution

YOK

Project Number

YOK

Thanks

-

Akut Miyokard Enfarktüsü Geçiren Genç Hastalarda Oksidatif Stres Belirteçleri ve Kardiyak Enzimlerle İlişkisi

Abstract

Amaç: Oksidatif stres ile akut miyokard infarktüsü (AMİ) arasındaki ilişki pek çok çalışma ile gösterilmiştir. Total antioksidan seviyesi (TAS), total oksidan seviyesi (TOS) ve oksidatif stres indeksi (OSI) oksidatif dengeyi yansıtır. Genç hastalarda AMİ'nin risk faktörleri, klinik özellikleri ve prognozu, yaşlı gruptan farklıdır. Bu çalışma TAS, TOS ve OSI'nin kantitatif ölçümü ile genç AMİ hastalarında 48 saat içerisindeki seyrini ve kardiyak belirteçlerle ilişkisini belirlemeyi amaçlamaktadır.

Gereç ve Yöntem: Bu prospektif, kontrollü çalışmaya 45 yaş ve al-tında AMİ tanısı almış 50 hasta ve kontrol grubu olarak 20 sağlıklı birey dahil edilmiştir. TOS ve TAS, venöz kan örneklerinden spektrofotometrik yöntemle ölçülmüştür. Oksidatif stres indeksi bu pa-rametreler üzerinden elde edilmiştir.

Bulgular: Toplam 50 hastanın kırkbeşi erkek ve ortalama yaş (36±6,8) idi. TOS ve OSI değerleri kontrol grubuna göre anlamlı olarak yüksek bulundu (p=0,002; p=0,005). TAS değerleri kontrol grubundan farklı bulunmadı (p=0,46). Sırasıyla CK 0. saat (s) ve TOS 0. s., CK-MB 0. s. ve TOS 0. s., CK 48. s. ve OSI 48. s., CK-MB 48. s. ve OSI 48. s. arasında anlamlı bir korelasyon olduğu bulundu (r=0,36, p=0,008; r=0,46, p=0,001; r=0,32, p=0,03; r=0,36, p<0,01).

Sonuç: Oksidatif stres AMİ'nin erken saatlerinde artmaktadır. TOS ve OSI değerleri, yalnızca belirli zaman dilimlerinde kardiyak belir-teçlerle ilişkilendirebilmekte ve genç AMİ hastalarında prognostik değerleri sınırlı olmaktadır. TAS, kardiyak belirteçlerle ilişkili bulunmamıştır.

Keywords

Total antioksidan seviyesi, total oksidan sevi-yesi, oksidatif stres indeksi, miyokard infarktüsü

Project Number

YOK

References

• 1. Bast A, Guido R. Oxidants and antioxidants. Am J Med 1991; 91(3C): 2-13. [CrossRef] google scholar
• 2. Cochrane CG. Cellular injury by oxidants. Am J Med 1991; 91(3C): 23-9. [CrossRef] google scholar
• 3. Jane A. Leopold, Antioxidants, and Coronary Artery Disease: From Pathophysiology to Preventive Therapy. Cor Art Dis 2015; 26(2): 176-83. [CrossRef] google scholar
• 4. Kasap S, Gonenc A, Sener DE. Serum cardiac markers in patients with acute myocardial infarction: oxidative stress, C-reactive protein, and N-Terminal pro-brain natriüretic peptide. J Clin Bioch Nut 2007; 41: 50-7. [CrossRef] google scholar
• 5. Barbara E, Miso S, Pavel P. Inflammation markers in young post-myo-cardial infarction patients exhibiting various expressions of classic coronary risk factors. Cor Art Dis 2006,17: 325-30. [CrossRef] google scholar
• 6. Caimi G, Valenti A, Prenti L. Acute myocardial infarction in young adults: evaluation of the hemorheological pattern at the initial stage after 3 and 12 months. Ann Ist Sup Son 2007; 43(2): 139-43. google scholar
• 7. D'Oria R, Schipani R, Leonardini A, Natalicchio A, Perrini S, Cignarelli A, et al. The Role of Oxidative Stress in Cardiac Disease: From Physiological Response to Injury Factor. Oxid Med Cell Lon-gev 2020; 5732956. [CrossRef] google scholar
• 8. Turan T, Menteşe Ü, Ağaç MT, Akyüz AR, Kul S, Aykan AÇ. The rela-tion between intensity and complexity of coronary artery lesion and oxidative stress in patients with acute coronary syndrome. Anatol J Cardiol 2014; 15(10): 795-800. [CrossRef] google scholar
• 9. Romuk E, Wojciechowska C, Jachec W, Nowak J, Niedziela J, Ma-linowska-Borowska J. Comparison of Oxidative Stress Parameters in Heart Failure Patients Depending on Ischaemic or Nonisch-aemic Aetiology. Oxid Med Cell Longev 2019; 7156038. [CrossRef] google scholar
• 10. Amanvermez R, Acar E, Günay M, Baydın A, Yardan T, Bek Y. Hsp 70, hs-CRP, and oxidative stress in patients with acute coronary syndromes. Bosn J of Basic Med Sci 2012; 12(2): 102-7. [CrossRef] google scholar
• 11. Chua SK, Hung HF, Shyu KG, Cheng JJ, Chiu CZ, Chang CM, et al. Acute ST-elevation Myocardial Infarction in Young Patients: 15 Years of Experience in a Single Center. Clin Cardiol 2010; 33(3): 140-8. [CrossRef] google scholar
• 12. Yıldırım N, Arat N. Comparison of traditional risk factors, natural history, and angiographic findings between coronary heart dis-ease patients with age <40 and > or =40 years old. Anatol J Cardi-ol, 2007; 7(2): 124-7. google scholar
• 13. Tungsubutra W, Tresukosol D, Buddhari W, Boonsom W, Sanguan-wang S, Srichaiveth B. Acute coronary syndrome in young adults; the Thai ACS registry. J Med Assoc Thai 1990; 1: 81-90. google scholar
• 14. Schoenenberger AW, Radovanovic D, Stauffer JC, Windecker S, Urban P, Niedermaier G, Acute coronary syndrome in young pa-tients; presentation, treatment, and outcome. Int J Cardiol 2011; 148(3): 300-4. google scholar
• 15. Colkesen AC, Acil T, Demircan S. Coronary lesion type, location, and characteristics of acute ST-elevation myocardial infarction in young adults under 35 years of age. Cor Ar Dis 2008; 19: 345-47. [CrossRef] google scholar
• 16. Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem 2005; 38(12): 1103-11. [CrossRef] google scholar
• 17. Ho HY, Chang ML. Oxidative damage markers, and antioxidants in patients with acute myocardial infarction and their clinical signifi-cance. Biofac 2008; 34(2): 135-45. [CrossRef] google scholar
• 18. Lo Presti, Catania A, D'Amica T, Montana M. Oxidative stress in young subjects with acute myocardial infarction: evaluation at the initial stage and after 12 months. Clin Appl Thromb Hem 2008; 14(4): 421-7. [CrossRef] google scholar
• 19. Soejima H, Suefuji H, Miyamoto S, Kajiwaram I, Kojimo S, Hoka-maki J, et al. Increased plasma thioredoxin in patients with acute myocardial infarction. Clin Card 2003; 26: 583-87. [CrossRef] google scholar
• 20. Himmetoglu S, Dincer Y, Bozcali E. Oxidative DNA damage and an-tioxidant defense after reperfusion in acute myocardial infarction. J Inv Med 2009; 57(4): 595-9. [CrossRef] google scholar
• 21. Mocatta TJ, Pilbrow AP,Cameron WA, Senthilmohan R, Frampton CM, Richards AM, et al. Plasma concentrations of myeloperoxi-dase predict mortality after myocardial infarction. JACC 2007; 22; 49(20): 2001-2. [CrossRef] google scholar
• 22. Serdar Z, Serdar A, Altın A. The relationship between oxidant and antioxidant parameters and severity of acute coronary syn-dromes. Act Card 2007; 62(4): 373-80. [CrossRef] google scholar
• 23. Shahzad S, Mateen S, Hasan A, Moin S. GRACE score of myocardial infarction patients correlates with oxidative stress index, hs-CRP, and inflammation. Immunobiology 2019; 224(3): 433-9. [CrossRef] google scholar
• 24. Aksoy S, Cam N, Gürkan U, Öz D, Özden K, Altay S, et al. Oxidative stress and severity of coronary artery disease in young smokers with acute myocardial infarction. Cardiol J 2012; 19: 381-6. [CrossRef] google scholar
• 25. Demirci B, Demir O, Dost T, Birincioglu M. Antioxidative effect of aspirin on vascular function of aged ovariectomized rats. AGE 2014; 36: 223-9. [CrossRef] google scholar
• 26. Kilit C, Koçak FE, Paşalı Kilit T. Comparison of the effects of high-dose atorvastatin and high-dose rosuvastatin on oxidative stress in patients with acute myocardial infarction: A pilot study. Turk Kardiyol Dern Ars 2017; 45(3): 235-43. [CrossRef] google scholar