Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.727
Index Copernicus  – 166.39
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 2, February, p. 185–191

doi: 10.17219/acem/64464

Publication type: original article

Language: English

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Oxidative stress markers predict early left ventricular systolic dysfunction after acute myocardial infarction treated with primary percutaneous coronary intervention

Dubravka Rajic1,A,B,C,D, Ivica Jeremic2,3,A,B,C,D, Sanja Stankovic4,B,C,E, Olivera Djuric3,5,C,D, Tatjana Zivanovic-Radnic2,B, Igor Mrdovic1,3,C,E,F, Predrag Mitrovic1,3,A, Dragan Matic1,3,B, Zorana Vasiljevic3,E, Mihailo Matic3,A,E, Milika Asanin1,3,C,E,F

1 Cardiology Clinic, Clinical Centre of Serbia, Belgrade, Serbia

2 Institute of Rheumatology, Belgrade, Serbia

3 School of Medicine, University of Belgrade, Serbia

4 Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia

5 Institute of Epidemiology, Belgrade, Serbia

Abstract

Background. Despite successful primary percutaneous coronary intervention (PCI) after ST-segment elevation myocardial infarction (STEMI), some patients develop left ventricular systolic dysfunction (LVSD) and acute heart failure (HF). Identifying patients with an increased risk of developing LVSD by means of biomarkers may help select patients requiring more aggressive therapy.
Objectives. The aim of this study was to evaluate the relationship between the levels of oxidative stress markers and development of LVSD and acute HF early after STEMI.
Material and Methods. The study enrolled 148 patients with the first STEMI, who were treated by primary PCI < 12 h from the onset of symptoms. We assessed the impact of different biomarkers for developing LVSD and acute HF (Killip ≥ 2) including: markers of necrosis – peak creatine kinase (CK), markers of myocardial stretch – B-type natriuretic peptide (BNP), inflammatory markers – C-reactive protein (CRP), leucocyte and neutrophil count, as well as oxidative stress markers – total thiol groups, catalase, superoxide dismutase (SOD) and glutathione reductase (GR).
Results. In multivariate analysis, thiol groups, peak CK, anterior wall infarction, and age were predictors of LVEF ≤ 40%. Out of 16 variables significantly associated with the Killip ≥ 2 in univariate logistic regression analysis, 5 appeared to be independently associated with acute HF in multivariate analysis: catalase, BNP, leucocytes, neutrophil count, and size of left atrium.
Conclusion. In this study, we have shown for the first time that thiol groups and catalase are independent predictors of STEMI complication – LVSD and acute HF, respectively. Beside routine used biomarkers of necrosis and myocardial stretch, thiol groups and catalase may provide additional information regarding the risk stratification.

Key words

oxidative stress, heart failure, acute myocardial infarction, percutaneous coronary intervention, left ventricular systolic dysfunction

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