title: The relationship between ischemia modified albumin and oxidative stress parameters in patients with cardiac syndrome X.
abstract: BACKGROUND
  The objective of this study was to evaluate the serum levels of ischemia modified albumin and oxidative stress parameters in patients with cardiac syndrome X.
  
  
  METHODS
  A total of 61 patients, composed of 32 consecutive patients (24 female, 8 male, average age: 47.63 +/- 9.49 years) diagnosed with cardiac syndrome X by coronary angiography (initially performed following the identification of ischemia by exercise stress test or myocardial perfusion scintigraphy) and a control group of 29 consecutive patients (15 female, 14 male, average age: 49.59 +/- 11.68 years) with similar features without cardiac syndrome X were included in the study. The levels of the ischemia modified albumin (IMA), ferric reducing antioxidant power (FRAP), prooxidant-antioxidant balance (PAB), and advanced protein oxidation products (AOPP) were determined by colorimetric methods.
  
  
  RESULTS
  Patients have significantly higher PAB, AOPP, and IMA levels in the patient group than in the control group (p < 0.01, p < 0.001, and p < 0.02, respectively). Also, serum triglyceride (p < 0.005) and hs-CRP (p < 0.0001) levels were significantly higher in the patient group (p < 0.01, p < 0.001, and p < 0.02, respectively). We found that there was a significant correlation between hs-CRP, plasma PAB (r: 0.258; p < 0.05), AOPP (r: 0.459; p < 0.001), and triglyceride levels (r: 0.404; p < 0.01). Plasma AOPP levels were also significantly positive correlated with triglyceride levels (r: 0.463; p < 0.001). In addition, during the correlation analysis performed on the patient group, a positive correlation was observed between the levels of IMA with the levels of plasma PAB and plasma AOPP (r: 0,994; p < 0.01 and r: 0.857; p < 0.05, respectively) In a multiple linear regression analysis, AOPP levels were significantly related with hs-CRP and triglyceride (R2: 0.380, p < 0.0001 and p < 0.05). Simple linear regression analysis was performed between plasma PAB (as dependent variable) and hs-CRP levels. Plasma PAB levels were related with hs-CRP (R2: 0.258, p < 0.05). Using the receiver-operator characteristic (ROC) curve, the best cut-off values for predicting cardiac syndrome X of PAD, AOPP, IMA, and hs-CRP levels were 88.1 arbitrary units, 68.5 kloramin T micromol/L, 7.17 U/mL, and 1.09 mg/dL, respectively.
  
  
  CONCLUSIONS
  Based on the results of our study, the increase in oxidative stress during cardiac syndrome X appears to be related to elevated levels of IMA. Treatment modalities that decrease oxidative stress might be beneficial for the treatment of cardiac syndrome X.
authors.affiliation: Department of Cardiology Bakirkoy Dr Sadi Konuk Education and Research Hospital, lstanbul, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Demir
authors.affiliation: Department of Medical Pharmacology and Clinical Pharmacology, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Ozyazgan
authors.affiliation: Kirklareli University, School of Health, Kirklareli, Turkey.
authors.forename: G G
authors.initials: GG
authors.lastname: Korkmaz
authors.affiliation: Department of Cardiology Bakirkoy Dr Sadi Konuk Education and Research Hospital, lstanbul, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Karakaya
authors.affiliation: Department of Cardiology Bakirkoy Dr Sadi Konuk Education and Research Hospital, lstanbul, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Aciksari
authors.affiliation: Department of Cardiology Bakirkoy Dr Sadi Konuk Education and Research Hospital, lstanbul, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Uygun
authors.affiliation: Department of Medical Pharmacology and Clinical Pharmacology, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Onal
authors.affiliation: Department of Medical Biochemistry, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul. Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Uzun
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D017566:Microvascular Angina / Q000097:blood*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood*; D018384:Oxidative Stress; D012709:Serum Albumin / Q000378:metabolism*
chemical_list: D012709:Serum Albumin