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Prognostic Value of Redox Status Biomarkers in Patients Presenting with STEMI or Non-STEMI: A Prospective
Zorica Savovic1, Bozidar Pindovic2, Maja Nikolic3
1Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.
Insights
Oxidative stress markers like superoxide anion radicals and reduced glutathione, alongside troponin I and NT-pBNP, can predict ST-elevation myocardial infarction evolution in early patient evaluations.
Area of Science:
- Cardiology
- Biochemistry
- Internal Medicine
Background:
- Oxidative stress (OS) plays a role in myocardial infarction (MI).
- Understanding redox balance is crucial for early MI evaluation.
- Differentiating between ST-elevated myocardial infarction (STEMI) and non-ST-elevated myocardial infarction (NSTEMI) is important.
Purpose of the Study:
- To determine the role of OS in the early evaluation of STEMI and NSTEMI patients.
- To define the role of redox balance in profiling MI development.
- To identify early predictors of ST evolution in MI.
Main Methods:
- Prospective observational case-control study.
- Inclusion of 40 STEMI and 39 NSTEMI patients.
- Blood sample collection for cardio-specific enzymes, OS biomarkers, and antioxidant enzymes at admission and 12 hours post-admission.
Main Results:
- Superoxide anion radicals were elevated in NSTEMI patients 6 hours post-admission.
- Hydrogen peroxide levels were significantly increased in the NSTEMI group.
- Positive correlation between superoxide anion radicals and troponin I; inverse correlation between reduced glutathione and NT-pBNP.
Conclusions:
- Superoxide anion radicals and reduced glutathione, along with hs-troponin I and NT-pBNP, may predict ST evolution.
- Redox balance markers are valuable in early MI assessment.
- These biomarkers can aid in profiling MI development and patient stratification.
Abstract:
(1) Background: The aim of our study was to determine the role of oxidative stress (OS) during early evaluation of acute ST-elevated myocardial infarction (STEMI) and non-ST-elevated myocardial infarction (NSTEMI) patients in order to define the role of redox balance in profiling the development of myocardial infarction (MI). (2) Methods: This prospective observational case-control study included 40 consecutive STEMI and 39 NSTEMI patients hospitalized in the coronary care unit of the cardiology clinic at the Kragujevac Clinical Center, Serbia, between 1 January 2016 and 1 January 2017. Blood samples were collected from all patients for measuring cardio-specific enzymes at admission and 12 h after admission to evaluate systemic oxidative stress biomarkers and the activity of antioxidant enzymes. (3) Results: In this study, participants were predominately female (52%), with a mean age of 56.17 ± 1.22 years old in the STEMI group and 69.17 ± 3.65 in the non-STEMI group. According to the Killip classification, the majority of patients (>50%) were at the second and third level. We confirmed the elevation of superoxide anion radicals in the non-STEMI group 6 h after admission in comparison with the STEMI and CTRL groups, but levels had decreased 12 h after admission. Levels of hydrogen peroxide were statistically significantly increased in the NSTEMI group. A positive correlation of superoxide anion radicals and levels of troponin I at admission was observed (r = 0.955; p = 0.045), as well as an inverse correlation between reduced glutathione and levels of NT-pBNP measured 6 h after admission (r = -0.973; p = 0.027). (4) Conclusions: We confirmed that superoxide anion radicals and reduced glutathione observed together with hs-troponin I at admission and NT-pBNP during hospital treatment could be predictors of ST evolution.
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