Vol.13, No 2, 2006 pp. 78 - 83
UC 616.132.2
OXIDANT STRESS AFTER CORONARY STENT IMPLEMENTATION
Svetlana Apostolović1, Zoran Perišić1,
Vladan Ćosić2, Ivana Stojanović3,
Miloje Tomašević1
1Clinic of Cardiology, Clinical Centre, Niš, Serbia
2Centre for Medical Biochemistry, Clinical Centre, Niš,
Serbia
3Institute of Biochemistry , Medical Faculty, Niš, Serbia
E-mail: sapos@sbb.co.yu
Summary. Literature data about oxidative stress in percutaneous
coronary interventions are still controversial. The intensity of oxidative
stress depends on the extent of ischemia, the degree of endothelial damage
and, also on the possibility of antioxidant protection. The aim of this
study was to determine the point at which the oxidative stress reaches
its maximum height and the point of oxidative balance restoration after
the stent implantation.The research included 22 patients with coronary
artery disease (CAD) (aged 51 ą 4 years), who have undergone coronary angiography,
with the indication for implantation of one stainless steel stent of the
length of 12-18 mm. Diabetic patients were excluded. Blood samples for
analysis were taken immediately before and after stent implantation as
well as 6, 12, 24, and 72 hours after stent implantation. We have analyzed
the parameters of free radical production – lipid peroxides (Lp) and xanthine
oxidase - (XO) and catalase, as the enzyme of antioxidant defense. All
parameters were determined in blood samples of 30 healthy persons at the
same time. The results have shown that in patients with coronary artery
disease there was a high level of oxidative stress before stent implantation
compared to control group of healthy ones (CG) (XO: CG 3.92 ą 0.88
vs. CAD 17.6 ą 1.28, p < 0.001), MDA (malondialdehyde) in plasma of
CG 8.29 ą 1.66 vs. CAD 10.39 ą 2.56 NS. There was no significant
difference in catalase (CAT) activity between patient group before stent
implantation and CG. The parameters of oxidative stress showed a slight
increase immediately after the stent implantation, while the activity of
catalase increased significantly. The values of prooxidant parameters normalized
72 hours after stent implementation. In patients with coronary heart disease,
there is an intensive oxidative stress before stent implantation, which
shows a slight temporary increase after stent implantation. It has no statistical
significance. On the other hand, a significant increase of the catalase
activity has been noticed after stent implantation, which indicates the
activation of anti oxidant defence system. The values of oxidative stress
parameters approach the values of those of the control group, 72 hours
after stent implantation.
Key words: Oxidative stress,
coronary stent
OKSIDATIVNI STRES NAKON UGRADNJE KORONARNOG
STENTA
Kratak sadržaj: Literaturni podaci o oksidativnom stresu u perkutanim
koronarnim intervencijama su jos uvek kontroverzni. Stepen oksidativnog
stresa zavisi od težine ishemije, intenziteta oštećenja endotela, ali i
od mogućnosti antioksidativne zastite. Cilj našeg istrazivanja je bio da
pokažemo kada je oksidativni stress najveći i kada se uspostavlja pro/antioksidativna
ravnoteža nakon ugradnje koronarnog stenta. Ispitivanjem su obuhvaćena
22 bolesnika (starosti 51 ą 4 godine) kojima je postavljena indikacija,
na osnovu prethodno uradjene koronarografije, za ugradnju jednog stenta
od nerđajućeg čelika, dužine 12-18 mm. U grupi nije bilo dijabetičara.
Krv za analizu je uzimana neposredno pre i nakon implantacije stenta, 6,
12, 24 i 72 časa od ugradnje stenta. Analizirani su parametri produkcije
slobodnih radikala – lipidni peroksidi (Lp) i ksantin oksidaza (XO) i katalaza,
kao enzim antioksidativne zaštite. Ujedno su isti parametri dobijeni iz
krvi 30 zdravih osoba. Rezultati pokazuju da pre ugradnje stenta postoji
visok oksidativni stress u koronarnih bolesnika (KB) u odnosu
na kontrolnu grupu zdravih (KG) (KG : XO 3,92 ą 0,88 vs KB XO 17,6 ą 1,28,
p < 0,001), MDA (malondialdehid) u plazmi KG 8,29 ą 1,66 vs KB 10,39
ą 2.56 NS. Ujedno postoji neznačajno viša aktivnost katalaze (KAT) pre
ugradnje stenta vs KG. Neposredno nakon ugradnje stenta neznačajno
su povećani parametri oksidativnog stresa, ali je zato značajno povišena
aktivnost katalaze. Vrednosti prooksidativnih parametra se normalizuju
72 sata nakon implantacije stenta. U uslovima koronarne bolesti, pre ugradnje
stenta, postoji intenzivni oksidativni stres. Nakon ugradnje stenta nastaje
prolazno, blago povećanje oksidativnog stresa, koje statistički nije značajno.
S druge strane, zapaženo je značajno povećanje aktivnosti katalaze nakon
ugradnje stenta, što ukazuje na aktivaciju sistema antioksidativne zaštite.
Vrednosti parametara oksidativnog stresa se približavaju vrednostima u
kontrolnoj grupi 72 sata nakon ugradnje stenta.
Ključne reči: oksidativni stres,
koronarni stent
