Z. Lominadze, K. Chelidze, L. Chelidze, E. Lominadze
{"title":"SYSTEMIC OXIDATIVE STRESS AS A SURROGATE OF CORONARY ATHEROSCLEROTIC PLAQUE INSTABILITY AND RUPTURE PREDICTOR","authors":"Z. Lominadze, K. Chelidze, L. Chelidze, E. Lominadze","doi":"10.11603/IJMMR.2413-6077.2020.1.11268","DOIUrl":null,"url":null,"abstract":"Background. Oxidative stress is crucial in developing broad spectrum of diseases, including atherosclerosis and related life-threatening conditions, such as acute coronary syndrome (ACS) mainly caused by atherosclerotic plaque vulnerability. Objective. To clarify the relation between oxidative stress and plaque instability we decided to compare oxidative profiles of patients with acute coronary syndrome (ACS) and with chronic coronary syndrome (CCS), evaluated at admission to the coronary care unit (CCU) of LTD Clinic-LJ (Kutaisi, Georgia) in April 2018 June 2019, who underwent successful primary percutaneous coronary intervention (PCI). Methods. 191 patients were enrolled (100 patients with ACS in Group 1 and 91 patients with CCS in Group 2) into the study. Using the CR3000 FORM PLUS (Callegari Srl, Catellani Group, Italy) – Callegari Point of Care instrument we evaluated free oxygen radical test (FORT), free oxygen radicals defense (FORD), calculated REDOX Index and the overall Profile of oxidative stress. Results. The mean/median concentration of Free Oxygen Radicals was significantly higher in the patients with ACS (404.37±9.83 Fort units/2.36 mmol/l H2O2 eq. vs 282.34±9.83 Fort units/2.36 mmol/l H2O2 eq., p<0.0001). Significant correlation was found between advanced oxidative stress and acute coronary syndrome (OR 14.42 95% CI (7.08-29.4), RR 3.26 95% CI (2.31-4.60) with high diagnostic characteristics (sensitivity of 82% and specificity of 92.3%; positive predictive value of 92% and positive likelihood ratio of 11). Conclusion. Oxidative stress is crucial in life-threatening acute coronary events. Measurement of overall oxidative stress profile, as a surrogate of plaque instability and rupture predictor, could help the clinicians in risk stratification and prevention of acute coronary syndrome (ACS).","PeriodicalId":14059,"journal":{"name":"International Journal of Medicine and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Medicine and Medical Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.11603/IJMMR.2413-6077.2020.1.11268","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background. Oxidative stress is crucial in developing broad spectrum of diseases, including atherosclerosis and related life-threatening conditions, such as acute coronary syndrome (ACS) mainly caused by atherosclerotic plaque vulnerability. Objective. To clarify the relation between oxidative stress and plaque instability we decided to compare oxidative profiles of patients with acute coronary syndrome (ACS) and with chronic coronary syndrome (CCS), evaluated at admission to the coronary care unit (CCU) of LTD Clinic-LJ (Kutaisi, Georgia) in April 2018 June 2019, who underwent successful primary percutaneous coronary intervention (PCI). Methods. 191 patients were enrolled (100 patients with ACS in Group 1 and 91 patients with CCS in Group 2) into the study. Using the CR3000 FORM PLUS (Callegari Srl, Catellani Group, Italy) – Callegari Point of Care instrument we evaluated free oxygen radical test (FORT), free oxygen radicals defense (FORD), calculated REDOX Index and the overall Profile of oxidative stress. Results. The mean/median concentration of Free Oxygen Radicals was significantly higher in the patients with ACS (404.37±9.83 Fort units/2.36 mmol/l H2O2 eq. vs 282.34±9.83 Fort units/2.36 mmol/l H2O2 eq., p<0.0001). Significant correlation was found between advanced oxidative stress and acute coronary syndrome (OR 14.42 95% CI (7.08-29.4), RR 3.26 95% CI (2.31-4.60) with high diagnostic characteristics (sensitivity of 82% and specificity of 92.3%; positive predictive value of 92% and positive likelihood ratio of 11). Conclusion. Oxidative stress is crucial in life-threatening acute coronary events. Measurement of overall oxidative stress profile, as a surrogate of plaque instability and rupture predictor, could help the clinicians in risk stratification and prevention of acute coronary syndrome (ACS).
背景。氧化应激在发展广泛的疾病中是至关重要的,包括动脉粥样硬化和相关的危及生命的疾病,如主要由动脉粥样硬化斑块易感性引起的急性冠状动脉综合征(ACS)。目标。为了阐明氧化应激与斑块不稳定之间的关系,我们决定比较急性冠状动脉综合征(ACS)和慢性冠状动脉综合征(CCS)患者的氧化谱,这些患者于2018年4月至2019年6月在LTD Clinic-LJ (Kutaisi, Georgia)冠状动脉监护室(CCU)入院时进行评估,并成功接受了初级经皮冠状动脉介入治疗(PCI)。方法:191例患者(1组为100例ACS患者,2组为91例CCS患者)纳入研究。使用CR3000 FORM PLUS (Callegari Srl, Catellani Group, Italy) - Callegari Point of Care仪器评估游离氧自由基测试(FORT),游离氧自由基防御(FORD),计算氧化还原指数和氧化应激的总体概况。结果。ACS患者的平均/中位自由基浓度明显高于ACS患者(404.37±9.83 Fort units/2.36 mmol/l H2O2 eq. vs 282.34±9.83 Fort units/2.36 mmol/l H2O2 eq., p<0.0001)。晚期氧化应激与急性冠脉综合征有显著相关性(OR 14.42 95% CI (7.08-29.4), RR 3.26 95% CI(2.31-4.60),具有较高的诊断特征(敏感性82%,特异性92.3%;阳性预测值92%,阳性似然比为11)。结论。氧化应激在危及生命的急性冠状动脉事件中至关重要。测量整体氧化应激谱,作为斑块不稳定性和破裂预测指标,可以帮助临床医生进行危险分层和预防急性冠脉综合征(ACS)。