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Are Thiols Useful Biomarkers for Coronary Collateral Circulation in Patients with Stable Coronary Artery Disease?

Yasemin Doğan1, Yücel Yilmaz1, Saban Kelesoğlu2

  • 1Department of Cardiology, Kayseri City Training and Research Hospital, University of Health Sciences, Kayseri 38080, Turkey.

Journal of Clinical Medicine
|October 14, 2023
PubMed

Insights

Lower levels of native thiol, total thiol, and disulfide predict poor coronary collateral circulation (CCC) in patients with stable coronary artery disease (sCAD). CCC formation is linked to the antioxidant, not inflammation, cascade.

Area of Science:

  • Cardiology
  • Biochemistry
  • Oxidative Stress

Background:

  • Coronary collateral circulation (CCC) plays a crucial role in mitigating ischemic damage in stable coronary artery disease (sCAD).
  • The antioxidant system, particularly thiols, is vital for cellular protection against oxidative stress.
  • The relationship between thiol levels and CCC in sCAD patients remains incompletely understood.

Purpose of the Study:

  • To investigate the association between thiol levels (native thiol, total thiol, disulfide) and the degree of CCC in patients with sCAD.
  • To identify independent predictors of poor CCC in this patient cohort.
  • To explore the role of the antioxidant cascade in CCC formation.

Main Methods:

  • Multivariate logistic regression analysis was employed to determine independent predictors of poor CCC.
  • Receiver Operating Characteristic (ROC) analysis was used to establish cut-off values for thiol and disulfide in predicting poor CCC.
  • Patients with sCAD and at least one occluded vessel (n=249) were categorized into good and poor CCC groups.

Main Results:

  • Diabetes Mellitus (DM), total thiol, and disulfide were identified as independent predictors of poor CCC.
  • ROC analysis indicated a native thiol cut-off of 328.7 (78% sensitivity, 67.4% specificity) and a disulfide cut-off of 15.1 (69.5% sensitivity, 57.9% specificity) for predicting poor CCC.
  • Patients with poor CCC exhibited significantly lower levels of native thiol, total thiol, and disulfide compared to those with good CCC.

Conclusions:

  • Thiol levels are significant predictors of coronary collateral circulation in patients with stable coronary artery disease.
  • CCC formation appears to be more closely associated with the antioxidant cascade than the inflammation cascade in sCAD.
  • These findings highlight the potential role of antioxidants in managing or improving collateral development in coronary artery disease.

Keywords:
coronary collateral circulationstable coronary artery diseasethiol

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