An oxidative stress score as a combined measure of the pro-oxidant and anti-oxidant counterparts in patients with coronary artery disease
Introduction
Inflammation and oxidative stress represent interrelated processes which play a key role in the pathogenesis and development of atherosclerosis [1]. However, at the moment, most available methods for evaluating oxidative stress in vivo are inappropriate for large-scale use, which limits their application in clinical practise [2], [3], [4]. Moreover, the choice of biomarkers indicating oxidative stress or anti-oxidant state in specific patient categories is still largely controversial [2], [3], [4].
Recently, we have described an improved protocol for the automated estimation of the derivatives of reactive oxygen metabolites and the total anti-oxidant status by using an automated clinical chemistry analyser [5], [6], [7]. This procedure optimizes standardization and allows high-throughput by reducing variability sources, with high reproducibility, consistent accuracy, and much smaller amounts of sera and reagents than required by conventional manual assays. Furthermore, we've also proposed the calculation of a simple oxidative stress index (Oxidative-INDEX), which reflects both the pro-oxidative and anti-oxidant counterparts, thus potentially more complete and powerful [7].
The present study aimed to apply this procedure to verify the relationship between the Oxidative-INDEX with traditional cardiovascular risk factors and C-reactive protein (CRP) levels in coronary artery disease (CAD).
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Subjects
A total of 170 subjects (mean age: 65 ± 10 years, 110 males) were enrolled in the study, according to previously described criteria [8], [9], and included 100 angiographically proven CAD patients and a group of 70 subjects as controls, who had no history or signs of cardiovascular disease, and who were screened for the presence of cardiovascular risk factors. All CAD patients, who had been recruited from the Clinical Cardiology Department of our Institute, underwent coronary angiography and
Results
The clinical characteristics of the study population according to the presence of CAD are presented in Table 1. As expected, patients with CAD were more likely to present risk factors such as smoking habit, dyslipidemia, diabetes and increased CRP levels. Likewise, CAD patients presented higher levels of hydroperoxides and lower total anti-oxidant capacity with respect to control subjects (422 ± 13 versus 328 ± 9 AU, p < 0.001 and 365 ± 12 versus 340 ± 8 μmol HClO/mL, respectively).
The distribution
Discussion
Although reactive oxygen species are normally produced by aerobic metabolism, the cellular redox status is normally maintained through the action of anti-oxidant systems [13]. However, disturbance of this balance may lead to a pro-oxidant situation when oxidative stress occurs [13]. In this status, reactive oxygen species may react with a variety of biological targets, including lipids, proteins, carbohydrates, nucleic acids, and induce indiscriminated damage to membranes, organelles, enzymes,
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