Antioxidants decrease reperfusion induced arrhythmias in myocardial infarction with ST-elevation.
In myocardial infarctions with ST-segment elevation, ischemia followed by reperfusion (IR) leads to arrhythmia, myocardial stunning and endothelial dysfunction injury by reactive oxygen species (ROS). To determine the impact of ROS, we examined the effect of antioxidant vitamins on biochemical changes and arrhythmias induced by reperfusion before and after therapeutic thrombolysis (Actilyse). As compared with those receiving placebo, in individuals who received antioxidants, there was a significant decrease in premature ventricular beats (100% vs 38%), atrial fibrillation (44% vs 6%), ventricular tachycardia (31% vs 0%), first-degree atrial-ventricular block (44% vs 6%), plasma malondialdehyde at the first hour after initiation of thrombolysis (1.07 +/- 0.10 vs 0.53 +/- 0.10 nmols plasma malondialdehyde/mg protein) and circulating neutrophils after 24 hr after reperfusion. The antioxidant capacity of plasma was increased from 1.89 +/- 0.15 to 3.00 +/- 0.31 units/mg protein and paraoxonase-1 rose from 0.77 +/- 0.08 to 1.27 +/- 0.11 nmol/min/mg protein. These findings suggest that antioxidants might be useful as adjuvants in controlling reperfusion induced arrhythmias following therapeutic alteplase thrombolysis.
Hicks
Juan J
JJ
Laboratorio de Bioquimica Inorganica, Departamento de Investigacion en Bioquímica y Medicina Ambiental, Instituto Nacional de Enfermedades Respiratorias, DF Mexico. jhicks@iner.gob.mx
Montes-Cortes
Daniel H
DH
Cruz-Dominguez
Maria P
MP
Medina-Santillan
Roberto
R
Olivares-Corichi
Ivonne M
IM
D000975:Antioxidants / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000209:etiology; D015415:Biomarkers / Q000378:metabolism; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D015428:Myocardial Reperfusion Injury / Q000150:complications*; D016277:Ventricular Function, Left; D014815:Vitamins / Q000627:therapeutic use
D000975:Antioxidants; D015415:Biomarkers; D008903:Minerals; D014815:Vitamins