Paraoxonase-1 activity and oxidative stress in patients with anterior ST elevation myocardial infarction undergoing primary percutaneous coronary intervention with and without no-reflow.
BACKGROUND
Reperfusion and ischemic injuries are pathogenetic mechanisms of no-reflow. Oxidative stress plays a critical role during ischemia as well as during the reperfusion phase following ST elevation myocardial infarction (STEMI). We sought to investigate the relationship between no-reflow with paraoxonase-1 (PON-1) activity and oxidative stress markers (total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), lipid hydro-peroxide (LOOH)) in patients with anterior STEMI undergoing primary percutaneous coronary intervention (PCI).


METHODS
In this study, 319 consecutive anterior STEMI patients undergoing primary PCI were prospectively included (mean age 56.5 ± 12.5 years). The patients were divided into two groups as normal flow (n = 231) and no-reflow (n = 88) groups. Serum PON-1 activity was measured spectrophotometrically. TAC and TOS levels were determined by using an automated measurement method. LOOH levels were measured by ferrous oxidation with xylenol orange assay.


RESULTS
PON-1 activity and TAC levels were significantly lower and TOS, OSI and LOOH levels were significantly higher in patients with no-reflow compared to normal flow group (p < 0.05, for all). On multivariate logistic regression analysis, PON-1 activity (β = 0.976, 95% CI = 0.962-0.990, p = 0.001) and OSI (β = 1.094, 95% CI = 1.042-1.148, p < 0.001) as well as diabetes, infarction time, thrombus score and initial SYNTAX score were independently associated with no-reflow.


CONCLUSIONS
In patients with no-reflow compared with normal flow, oxidants are increased, while serum PON-1 activity and antioxidants are decreased. This result shows that increased oxidative stress has a role in the pathogenesis of no-reflow.
Adana Numune Training and Research Hospital, Department of Cardiology, Adana, Turkey. Electronic address: drmugur@yahoo.com.
Mustafa
M
Gür
Adana Numune Training and Research Hospital, Department of Cardiology, Adana, Turkey.
Caner
C
Türkoğlu
Harran University, School of Medicine, Department of Clinical Biochemistry, Sanliurfa, Turkey.
Abdullah
A
Taşkın
Adana Numune Training and Research Hospital, Department of Cardiology, Adana, Turkey.
Hakan
H
Uçar
Kafkas University, School of Medicine, Department of Cardiology, Kars, Turkey.
Abdurrezzak
A
Börekçi
Adana Numune Training and Research Hospital, Department of Cardiology, Adana, Turkey.
Taner
T
Seker
Mersin State Hospital, Department of Internal Medicine, Mersin, Turkey.
Mehmet Yavuz
MY
Gözükara
Adana Numune Training and Research Hospital, Department of Cardiology, Adana, Turkey.
Onur
O
Kaypaklı
Adana Numune Training and Research Hospital, Department of Cardiology, Adana, Turkey.
Selahattin
S
Akyol
Harran University, School of Medicine, Department of Clinical Biochemistry, Sanliurfa, Turkey.
Sahbettin
S
Selek
Adana Numune Training and Research Hospital, Department of Cardiology, Adana, Turkey.
Durmuş Yıldıray
DY
Sahin
Adana Numune Training and Research Hospital, Department of Cardiology, Adana, Turkey.
Zafer
Z
Elbasan
Adana Numune Training and Research Hospital, Department of Cardiology, Adana, Turkey.
Murat
M
Caylı
D000328:Adult; D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000628:therapy*; D000975:Antioxidants / Q000378:metabolism; D043303:Aryldialkylphosphatase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008054:Lipid Peroxides / Q000097:blood; D008297:Male; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000097:blood / Q000201:enzymology* / Q000209:etiology; D016877:Oxidants / Q000097:blood; D018384:Oxidative Stress; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D000975:Antioxidants; D015415:Biomarkers; D008054:Lipid Peroxides; D016877:Oxidants; D043303:Aryldialkylphosphatase; C468406:PON1 protein, human
Antioxidant; Myocardial infarction; No-reflow; Oxidative stress; Paraoxonase