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Is oxidative stress causally linked to unstable angina pectoris? A study in 100 CAD patients and matched controls
K Kostner1, S Hornykewycz, P Yang
1Department of Cardiology, University of Vienna, Austria.
Insights
Lipid peroxidation products are elevated in patients with unstable angina pectoris (UAP), distinguishing them from stable angina pectoris (SAP) patients. This highlights the role of oxidative stress in coronary artery disease progression.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Oxidative Stress Research
Background:
- Unstable angina pectoris (UAP) is a critical precursor to acute myocardial infarction.
- Lipid peroxidation is implicated in the pathogenesis of atherosclerosis and coronary artery disease.
- Assessing oxidative stress markers may aid in differentiating angina pectoris subtypes.
Purpose of the Study:
- To measure lipid peroxidation products and vitamin E levels in patients with coronary artery disease.
- To compare these markers between patients with stable angina pectoris (SAP) and unstable angina pectoris (UAP).
- To evaluate the relationship between oxidative stress and coronary artery disease severity.
Main Methods:
- Studied 50 SAP patients, 50 UAP patients, and 100 healthy controls.
- Measured malondialdehydes (TBARS), lipid hydroperoxides, and conjugated dienes.
- Quantitated serum alpha-tocopherol (vitamin E) using HPLC and assessed alpha-tocopherol per LDL particle.
Main Results:
- UAP patients exhibited significantly higher levels of peroxides and TBARS compared to SAP patients and controls.
- Conjugated dienes were also elevated in UAP patients relative to SAP patients.
- While total alpha-tocopherol was similar across groups, alpha-tocopherol content per LDL particle was lowest in UAP patients.
Conclusions:
- Lipid peroxidation parameters are significantly increased in patients with unstable angina pectoris.
- These markers effectively differentiate between stable and unstable angina pectoris.
- Elevated oxidative stress is a key feature distinguishing UAP from SAP.
Objective:
Unstable angina pectoris often leads to acute myocardial infarction. Since lipid peroxidation is thought to be causally related to chronic and acute events in atherosclerosis and coronary artery disease, we measured lipid peroxidation products and vitamin E in 100 patients with coronary artery disease and compared them to a matched control group.
Methods:
50 consecutive patients with stable angina pectoris (SAP) and 50 consecutive patients with unstable angina pectoris (UAP) were studied and compared to 100 clinically healthy individuals. In addition to conventional lipid and lipoprotein analysis, malondialdehydes were measured as thiobarbituric acid reactive substances (TBARS). Lipid hydroperoxides were assayed with the colorimetric methylene blue method. alpha-Tocopherol was quantitated by HPLC after extraction of serum with hexane-ethanol. In the patient group conjugated dienes were also measured.
Results:
As expected, patients had significantly higher cholesterol, triglyceride LDL-C and Lp(a) values and lower HDL-C values than controls. When patients were divided into groups with SAP and UAP respectively, peroxides and TBARS were significantly higher in the latter group as compared to patients with SAP and to controls. Conjugated dienes were also significantly higher in patients with UAP as compared to patients with SAP. Total plasma alpha-tocopherol was comparable in all three groups, whereas the alpha-tocopherol content per LDL particle was lowest in patients with UAP, followed by patients with SAP and then controls.
Conclusion:
It is concluded that lipid peroxidation parameters are increased in patients with UAP and discriminate SAP from UAP patients.