title: Apoptosis kinetics at reperfusion period in patients with acute ST-Segment Elevation Myocardial Infarction undergoing primary percutaneous coronary intervention and treated with thrombolytic therapy.
abstract: OBJECTIVE
  To evaluate the kinetics of cardiomyocyte apoptosis in patients undergoing primary percutaneous coronary intervention and thrombolytic therapy in order to elucidate the dark side of reperfusion injury.
  
  
  METHODS
  The prospective descriptive study was conducted at Istanbul University Cardiology Institute, Istanbul, Turkey, between June 2010 and December 2012. It comprised patients with persistent ST-segment elevation myocardial infarction who were divided into two groups. Patients in group 1 were treated with percutaneous coronary intervention, while those in group 2 received thrombolytic therapy. Cell death detection enzyme-linked immunosorbent assay kit was used for the analysis of cardiomyocyte apoptosis. Venous blood samples were collected to determine the apoptotic activity from the patients at the beginning of thrombolysis in myocardial infarction grade 3 of reperfusion in infarct-related artery according to thrombolysis in myocardial infarction classification, and after reperfusion provided at 6, 12, 24 and 72 hours. Creatine kinase, peak creatine kinase myocardial band and troponin levels were determined on admission and during 24hours of ST-segment elevation myocardial infarction . SPSS 15 was used for statistical analysis.
  
  
  RESULTS
  There were 92 patients in the study; 48(51.6%) in group 1 and 44(48.4%) in group 2.There was no significant correlation between peak apoptotic activity levels at 72 hours of reperfusion and peak creatine kinase myocardial band (r=0.05;p=0.66) or the troponin (r=0.10;p=0.38) levels at 24 hours of ST-segment elevation myocardial infarction. Apoptotic activity levels increased at 72 hours compared to the baseline both for group 1 (p<0.001) and group 2(p<0.001).
  
  
  CONCLUSIONS
  Reperfusion injury was not primarily related to apoptosis and it was a slowly progressive benign event in patients with ST-segment elevation myocardial infarction-acute coronary syndrome. Also, the negative impact of percutaneous coronary intervention was not available on reperfusion injury.
authors.affiliation: Department of Cardiology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
authors.forename: Nazmi
authors.initials: N
authors.lastname: Gultekin
authors.affiliation: Department of Cardiology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
authors.forename: Gulsum
authors.initials: G
authors.lastname: Bulut
authors.affiliation: Laboratory of Microbiology and Clinical Microbiology, Istanbul University Cardiology Institute, Istanbul, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Kucukates
authors.affiliation: Department of Cardiology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Yildiz
authors.affiliation: Department of Cardiology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Kocas
authors.affiliation: Department of Biochemistry, Istanbul University, Istanbul Medical Faculty, stanbul, Turkey.
authors.forename: Leyla
authors.initials: L
authors.lastname: Bulut
mesh_terms: D000368:Aged; D017209:Apoptosis; D052279:Creatine Kinase, MB Form / Q000097:blood; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D032383:Myocytes, Cardiac / Q000378:metabolism / Q000473:pathology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods; D011446:Prospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D013223:Statistics as Topic; D015912:Thrombolytic Therapy / Q000009:adverse effects; D014336:Troponin / Q000097:blood; D014421:Turkey
chemical_list: D014336:Troponin; D052279:Creatine Kinase, MB Form
keywords: Apoptosis kinetics, ST-segment elevation, Acute coronary syndrome, Primary percutaneous coronary intervention, Thrombolytic therapy.