Elevation of the glycoxidation product N(epsilon)-(carboxymethyl)lysine in patients presenting with acute myocardial infarction.
BACKGROUND
An important role in the acceleration of vascular disease has been previously suggested for advanced glycation end products. N(epsilon)-(carboxymethyl)lysine (CML) is an advanced glycation end product formed on protein by combined non-enzymatic glycation and glycoxidation reactions. CML reacts with the receptor of advanced glycation end products inducing impairment of endothelium dependent relaxation and is a marker of oxidative stress.


METHODS
A total of 40 patients with acute myocardial infarction (17 patients with ST-elevation myocardial infarction, 23 patients with non-ST-elevation myocardial infarction) and 40 patients with stable coronary artery disease were included consecutively in this study. During coronary angiography, peripheral venous blood sample was taken for measuring CML.


RESULTS
Serum levels of CML were significantly increased in patients with acute myocardial infarction [17.9+/-10.7 vs. 6.6+/-3.1 arbitrary units (AU)/mg protein, p<0.001]. A cut-off value of CML>9.5 AU/mg protein was associated with an odds ratio of acute myocardial infarction of 39.7 [95% confidence interval (CI): 11.1-142, p<0.001], a sensitivity of 0.85 (95% CI: 0.70-0.94) and a specificity of 0.88 (95% CI: 0.73-0.96).


CONCLUSIONS
CML levels are significantly elevated in patients presenting with acute myocardial infarction. These results suggest the involvement of endothelial dysfunction (through receptor interaction) and oxidative stress in acute myocardial infarction.
Kralev
Stefan
S
I. Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany. stefan.kralev@med.ma.uni-heidelberg.de
Zimmerer
Elke
E
Brueckmann
Martina
M
Lang
Siegfried
S
Kälsch
Thorsten
T
Rippert
Anja
A
Lin
Jihong
J
Borggrefe
Martin
M
Hammes
Hans-Peter
HP
Süselbeck
Tim
T
D000208:Acute Disease; D000368:Aged; D005260:Female; D006027:Glycosides / Q000378:metabolism*; D006801:Humans; D008239:Lysine / Q000031:analogs & derivatives* / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D010084:Oxidation-Reduction
D006027:Glycosides; C048496:N(6)-carboxymethyllysine; D008239:Lysine