The role of thiol levels in predicting contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention

Abstract

OBJECTIVE:Contrast-induced nephropathy (CIN) is a common complication of diagnostic or interventional procedures that may arise from administration of intravascular contrast media. Recent studies have reported the thiol-disulfide ratio as a novel oxidative stress marker. Therefore, we investigated the role of thiol levels in predicting CIN in patients with ST-segment elevation myocardial infarction (STEMI) who had undergone primary percutaneous coronary intervention (PCI).METHODS:A total of 302 patients were enrolled in the study. CIN was defined as an increase in serum creatinine concentration ≥0.5 mg/dL compared with the admission value or a >25% relative rise during the first 48–72 hours after the procedure. To evaluate the relationship between thiol levels and CIN, the patients were divided into a CIN group and a non-CIN group.RESULTS:CIN occurred in 44 (15%) patients. Native thiol (274.8±84.7 μmol/L vs. 220.8±97.1 μmol/L, p=0.001) and total thiol (305.4±89.7 μmol/L vs. 260.1±102.1 μmol/L, p=0.009) levels were higher in patients within the non-CIN group. Disulfide (15.8±6.6 μmol/L vs. 19.6±8.4 μmol/L, p=0.002) levels, and mean disulfide/total thiol ratios (8.4±3.7 vs. 5.9±3.1, p=0.001) were higher in patients with CIN (+) group. In univariate analysis, the initial native thiol, total thiol, disulfide levels, and disulfide/total thiol ratio were found to have prognostic significance in the development of CIN. In the multivariate regression analysis, only the disulfide/total thiol ratio (OR=1.190; 95% CI: 1.090–1.300; p=0.001) was significantly and independently associated with CIN. The cutoff value of the disulfide/total thiol ratio to predict CIN on admission in patients with STEMI who underwent primary PCI was 7, with a sensitivity of 68.2% and a specificity of 79.8%.CONCLUSION:Our results suggest that thiol/disulfide homeostasis could be a good biochemical risk marker for CIN in STEMI patients who underwent primary PCI.

Protective Mechanism of Trimetazidine in Myocardial Cells in Myocardial Infarction Rats through ERK Signaling Pathway

“…Wang et al [ 3 ] studied and found that myocardial apoptosis occurs in the MI region and infarction border region, which is controlled by a series of programs, and it can be reduced via intervention. The prompt surgical intervention and thrombolytic drugs can restore cardiac blood supply, inhibit ischemic myocardial cell death and ventricular remodeling, and significantly improve cardiac function [ 4 ]. Trimetazidine, a 3-ketoacyl-CoA thiolase inhibitor, can inhibit the oxidative phosphorylation of fat and glucose, enhance the myocardial function, and protect the myocardial cells, which is used clinically in the antiangina treatment [ 5 ].…”

The Role of Thiol-Disulfide Hemostasis in Predicting Renal İnjury After Coronary Artery Bypass Graft Surgery

“…According to our information in the results of our literature review, our study is one of the rare studies investigating AKI after CABG surgery accompanied by CPB, and dynamic thiol-disulfide hemostasis parameters were measured. Another study investigating the relationship between AKI and thioldisulfide hemostasis was done by Korkmaz et al (16).…”