Oxidative Stress and Myocardial Damage during Elective Percutaneous Coronary Interventions and Coronary AngiographyA Comparison of Blood-borne Isoprostane and Troponin Release

Abstract

The role of oxidative stress in clinical cardiology is still controversial. The aims of the present study were to examine if minor ischaemic episodes as may occur during elective percutaneous coronary intervention (PCI) induce oxidative stress and, eventually, if oxygen stress correlates with myocardial injury. Thirty eight and nine patients underwent PCI and diagnostic coronary angiography, respectively. Peripheral blood was sampled at different time points for plasma analyses of: 8-iso-PGF2alpha (free radical-mediated oxidative stress); 15-keto-dihydro-PGF2alpha (cyclooxygenase-mediated inflammation); troponin-T (myocardial injury); hsCRP, vitamin A and vitamin E; and, total antioxidants status (TAS). In both groups 8-iso-PGF2alpha increased transiently by approximately 80% (p < 0.001) during the procedure. There was a minor troponin-T release (p < 0.001) after PCI, but no correlation with 8-iso-PGF2alpha. Troponin-T did not increase after angiography. 15-keto-dihydro-PGF2alpha decreased by 50% after ended procedure, but increased by 100% after 24 h compared to baseline. hsCRP increased significantly (p < 0.001) from baseline to the next day in the PCI-group, but not in the angiography group. Vitamins and TAS decreased slightly after the procedures. It is concluded that a moderate oxidative stress was induced by both elective PCI and coronary angiography but that no correlation was found between oxidative stress and myocardial injury in this setting. This indicates that other mechanisms than ischaemia-reperfusion episodes caused an elevation in plasma isoprostane such like the injury at a vascular site mutual for both procedures. A secondary finding from the study was elevated markers of early inflammatory response, not only after PCI, but also after angiography.

Intravenous Ascorbic Acid Infusion Improves Myocardial Perfusion Grade During Elective Percutaneous Coronary Intervention

“…Thus, F 2 -IPs exert a vasoconstriction effect on the arterial wall (56 -58) and could be responsible for post-PCI no-reflow phenomenon as they sharply increase after PCI (11,12,29). A recent study, however, showed that after PCI the local (coronary) blood concentration was too low to exert a coronary vasoconstriction effect (59).…”

ReviewIsoprostanes: Novel Bioactive Products of Lipid Peroxidation

“…[106 -108,173] In a large cross-sectional study in elderly men (77 years) it was shown that the 24-h urinary level of 8-iso-PGF 2a was significantly higher in men with type 2 diabetes ðn ¼ 101Þ than in the control men ðn ¼ 585Þ of the same age. [109] However, in a sub-group of these patients with disease duration , 7 years, diagnosis did not show any [96] Atherosclerotic lesion Elevated Gniwotta [97] Atherosclerotic lesion Elevated Mehrabi [98] Coronary artery Elevated Cardiopulmonary bypass Ulus [101] Plasma Elevated Delanty [100] Urine Elevated Angioplasty/PCI/ Coronary reperfusion Reilly [102] Urine Elevated Berg [155] Plasma Elevated Iuliano [103] Coronary sinus Elevated Angiography…”

“…Berg [155] Plasma Elevated Heart failure Crawcowski [105] Urine Elevated Mallat [104] Pericardial fluid Elevated Hypertension…”

F2-isoprostane induced prostaglandin formation in the rabbit

“…This reaction mainly occurs independent of cyclooxygenases (COX) in the body. 8-Iso-PGF 2a , one of the major isoprostanes, exibits potent biological activity and is increased in peripheral plasma and urine in several syndromes that are considered to be associated with oxidant injury, and also after daily intake of some polyunsaturated fatty acids [2][3][4][5][6][7][8][9][10][11].…”