title: Comparison of urinary biopyrrin levels in acute myocardial infarction (after reperfusion therapy) versus stable angina pectoris and their usefulness in predicting subsequent cardiac events.
abstract: We examined the relation between oxidative stress and cardiac events in patients with acute myocardial infarction (AMI). There is now increasing evidence that reactive oxygen species cause reperfusion injury to the previously ischemic myocardium after reperfusion. We measured urinary biopyrrin/creatinine levels, an oxidative stress marker, in 41 patients with AMI, 34 patients with stable angina pectoris (SAP), and 29 control subjects. In the patients with AMI, urine samples were taken before, at 4 and 24 hours, and at 1 and 2 weeks after reperfusion therapy. Of these 41 patients with AMI, 38 received reperfusion therapy, and the urinary biopyrrin/creatinine levels (micromol/g.creatinine) before reperfusion were significantly higher than those of the other 2 groups (AMI 4.24 +/- 0.49, SAP 2.45 +/- 0.15, control subjects 2.31 +/- 0.16; p = 0.0003 vs AMI). The onset of reperfusion significantly increased the levels of urinary biopyrrins/creatinine, and this time course was mapped out, peaking at 4 hours (8.21 +/- 0.96 vs 4.24 +/- 0.49 before, p = 0.0001), and decreasing to control levels between 24 hours and 7 days. The peak levels of urinary biopyrrins/creatinine were higher in the positive cardiac event group than in the negative cardiac event group (11.89 +/- 1.77 vs 7.57 +/- 1.00 micromol/g.creatinine, p = 0.029). These findings add further evidence that oxidative stress contributes to the complications of reperfusion injury, and suggest that urinary assessment of biopyrrins may be useful in predicting subsequent cardiac events after reperfusion in AMI.
authors.affiliation: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Honjo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimomura
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Keiji
authors.initials: K
authors.lastname: Takazoe
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Soejima
authors.forename: Shinzo
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawano
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Suefuji
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nishikawa
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Arai
authors.forename: Jun
authors.initials: J
authors.lastname: Hokamaki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kajiwara
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kugiyama
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000652:urine*; D001663:Bilirubin / Q000031:analogs & derivatives*; D008076:Cholesterol, HDL / Q000097:blood; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy* / Q000652:urine*; D015425:Myocardial Reperfusion; D018384:Oxidative Stress; D011237:Predictive Value of Tests; D011758:Pyrroles / Q000652:urine*; D012016:Reference Values
chemical_list: D008076:Cholesterol, HDL; D011758:Pyrroles; D003404:Creatinine; D001663:Bilirubin