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Relationship between Oxidative Stress Markers and Presence of Chronic Total Occlusion in Coronary Artery Disease
Ekrem Aksu1, Enes Celik1, Musa Dagli1
1Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Insights
Lower levels of vitamin C and vitamin A, and a reduced vitamin C/vitamin E ratio, may predict the risk of chronic total occlusion (CTO) in patients with stable coronary artery disease.
Area of Science:
- Cardiology
- Biochemistry
- Nutritional Science
Background:
- Chronic total occlusion (CTO) is a significant challenge in managing stable coronary artery disease.
- Oxidative balance plays a role in the development of cardiovascular conditions.
- Understanding predictors for CTO is crucial for risk stratification.
Purpose of the Study:
- To investigate the association between chronic total occlusion (CTO) and markers of oxidative stress.
- To determine if specific antioxidant vitamins can predict CTO development in stable coronary artery disease patients.
Main Methods:
- A cohort study was conducted with patients undergoing coronary angiography for stable chest pain.
- Serum levels of total oxidant/antioxidant status, thiol/disulfide dynamics, and antioxidant vitamins (A, C, E) were compared between patients with and without CTO.
- Statistical analysis, including area under the curve (AUC) for prediction, was performed.
Main Results:
- While general oxidative stress markers were similar, serum vitamin C and vitamin A levels were significantly lower in the CTO group.
- A lower vitamin C/vitamin E ratio was also observed in patients with CTO.
- These lower vitamin levels and ratio were predictive of CTO lesions.
Conclusions:
- Reduced serum vitamin C and vitamin A levels, along with a low vitamin C/vitamin E ratio, may serve as potential biomarkers for predicting CTO risk.
- These findings could aid in identifying stable coronary artery disease patients at higher risk for CTO.
Objective:
To investigate the relationship between chronic total occlusion (CTO) development and oxidative stress markers in stable coronary artery patients.
Study Design:
A cohort study.
Place And Duration Of Study:
Cardiology Clinic, Kahramanmaras Sutcu Imam University Medical Faculty, between January 2018 and December 2019.
Methodology:
Patients, who underwent coronary angiography for stable chest pain, were consecutively included. The study group consisted of those with CTO and the control group from those without CTO. Serum total oxidant/anti-oxidant, dynamic thiol/disulfide, antioxidant (ascorbate, alfa-tocopherol, beta-carotene) vitamin levels, and routine biochemistry tests of the patients were compared.
Results:
The study group (24 men, 5 women, mean age 63.79 ± 9.21 years) and control group (23 men, 6 women, mean age 61.38 ± 8.20 years) consisted of 29 patients each. The oxidative stress markers (total thiol, native thiol, disulfide, reduced thiol ratio, oxidized thiol ratio, thiol oxidation-reduction ratio, total antioxidant status, total oxidant status, and vitamin E) were found to have similar values between the groups. However, of the anti-oxidative vitamins, vitamin C, vitamin A and vitamin C/vitamin E ratio were significantly lower in the CTO group and predicted a CTO lesion (AUC: 0.084, p<0.001, 95% CI: 0.007-0.162; AUC: 0.285, p=0.005, 95% CI: 0.154-0.416 and AUC: 0.181, p <0.001, 95% CI: 0.062-0.299, respectively).
Conclusion:
The lower serum vitamin C and vitamin A levels and low vitamin C/vitamin E ratio may be useful in predicting the risk of CTO in stable patients with non-critical stenosis in coronary angiography.
Key Words:
Chronic total occlusion, Oxidative balance, Stable coronary artery disease, Vitamin A, Vitamin C, Vitamin C / vitamin A ratio.
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