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Plasma antioxidants and lipid peroxidation in acute myocardial infarction and thrombolysis
Y Levy1, P Bartha, A Ben-Amotz
1Lipid Research Unit, Rambam Medical Center, Haifa, Israel.
Insights
Acute myocardial infarction (AMI) patients exhibit lower antioxidant vitamins and increased lipid peroxidation after streptokinase (STK) therapy, indicating free radical involvement in reperfusion injury.
Area of Science:
- Cardiology
- Biochemistry
- Free Radical Research
Background:
- Acute myocardial infarction (AMI) is a critical condition requiring prompt treatment.
- Understanding the oxidative stress balance during therapy is crucial for managing AMI.
- Streptokinase (STK) is a common thrombolytic agent used in AMI treatment.
Purpose of the Study:
- To investigate the prooxidative and protective mechanisms in AMI patients undergoing STK therapy.
- To assess the impact of STK on plasma antioxidant levels and lipid peroxidation.
- To explore the role of free radicals in reperfusion injury following AMI treatment.
Main Methods:
- Blood samples collected from AMI patients before, and 2 and 24 hours after STK administration.
- Analysis of plasma lipid peroxidation using a free radical generating system (AAPH).
- Quantification of malondialdehyde equivalents, conjugated dienes, and plasma vitamins A, E, and beta-carotene via HPLC.
- Comparison of patient results with age-matched healthy controls.
Main Results:
- AMI patients presented with reduced baseline plasma antioxidant vitamin concentrations compared to controls.
- STK therapy led to a significant decrease in plasma vitamin E levels.
- Successful reperfusion correlated with increased plasma oxidizability.
- No significant difference in plasma lipids, except for lower HDL-cholesterol in AMI patients.
Conclusions:
- AMI patients experience a reduction in plasma antioxidant vitamins during thrombolysis.
- Thrombolysis with STK enhances lipid peroxidation, suggesting increased free radical generation.
- These findings highlight the role of free radicals in AMI reperfusion injury and suggest potential benefits of antioxidant therapy.
Objectives:
The aim of this study was to investigate the balance between prooxidative and protective mechanisms in patients with acute myocardial infarction (AMI) throughout streptokinase (STK) therapy.
Methods:
Patients who presented to coronary care unit within 3 hours of infarction were followed. Blood was collected before, 2 and 24 hours post STK. Plasma lipid peroxidation was analyzed by a free radical generating system (AAPH) and malondialdehyde equivalents and conjugated dienes quantitated. Plasma vitamins A, E and beta-carotene, were analyzed by HPLC. Patients' results were compared with those from age-matched, healthy control subjects.
Results:
In 38 patients with AMI, baseline plasma antioxidant vitamin concentration was reduced compared with a healthy control group. Upon STK therapy, there was a significant drop in plasma vitamin E concentration. Successful reperfusion was followed by an increased plasma oxidizability. Plasma lipids were not significantly different in the AMI patients except for a lower HDL-cholesterol concentration.
Conclusions:
Patients with AMI showed a drop in plasma antioxidant vitamins. Upon thrombolysis, there was an enhanced lipid peroxidation. These alterations indicate the significance of free radical generation processes in reperfusion injury in AMI patients, and suggest the potential involvement of antioxidants in the management of AMI treated by thrombolysis.