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Free-radical activity after primary coronary angioplasty in acute myocardial infarction
E D Grech1, C M Bellamy, M J Jackson
1Department of Cardiology, Cardiothoracic Centre, Liverpool, England.
Insights
Successful coronary angioplasty for acute myocardial infarction significantly increases free-radical activity, measured by the percentage molar ratio (PMR) of conjugated dienes. This suggests a risk of reperfusion injury from free radicals post-procedure.
Area of Science:
- Cardiology
- Biochemistry
- Medical Research
Background:
- Acute myocardial infarction (AMI) requires prompt restoration of blood flow.
- Primary percutaneous coronary intervention (PCI) is a standard treatment for AMI.
- Reperfusion injury, potentially mediated by free radicals, can occur after restoring blood flow.
Purpose of the Study:
- To assess free-radical activity in coronary venous outflow after successful recanalization in AMI patients.
- To investigate the relationship between primary PCI and free-radical generation.
- To determine the potential risk of free radical-mediated reperfusion injury.
Main Methods:
- Assessed free-radical activity in nine AMI patients undergoing primary PCI.
- Measured percentage molar ratio (PMR) of conjugated dienes and malonaldehyde in coronary venous outflow over 24 hours.
- Compared pre-angioplasty levels with post-reperfusion measurements.
Main Results:
- Pre-angioplasty PMR was within the normal range.
- A significant increase in PMR was observed shortly after successful recanalization, peaking between 2 and 60 minutes.
- No significant changes in malonaldehyde concentration were detected.
Conclusions:
- Successful recanalization of the infarct-related artery is associated with markedly elevated free-radical activity.
- The percentage molar ratio (PMR) of conjugated dienes is a sensitive marker for this activity.
- Patients undergoing successful primary PCI for AMI may be at risk of free radical-mediated reperfusion injury.
Abstract:
Free-radical activity in coronary venous outflow was assessed before and after reperfusion in nine patients with acute infarction who had undergone successful recanalization of the infarct-related artery by primary coronary angioplasty. Free-radical activity was measured in serum samples from coronary venous outflow over a timed period of 24 hours by using (1) the percentage molar ratio (PMR) of the diene conjugate 9,11-linoleic acid, and (2) malonaldehyde concentration. Preangioplasty PMR means lay within the normal range, but showed a marked increase soon after successful recanalization. Relative to baseline, the changes over time reached statistical significance between 2 and 60 minutes. No statistically significant changes in malonaldehyde occurred over the study period. We conclude that successful recanalization of the infarct artery is associated with significantly elevated free-radical activity, as measured by the PMR of conjugated diene, in coronary venous outflow. Such patients may be at risk from free radical mediated reperfusion injury.