Oxidative stress and its association with ST resolution and clinical outcome measures in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention

Abstract

Reperfusion of ischemic myocardium generates oxidative stress, which itself can mediate myocardial injury. We investigated the level of oxidative stress markers and its association with clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. Materials and methods: This cross-sectional study was conducted on 200 consecutive patients with STEMI in Tabriz, Iran during 2018. Enrolled patients were divided into 2 groups according to their thrombolysis in myocardial infarction (TIMI) flow grade: group A (100 patients, TIMI<2) and group B (100 patients TIMI≥2). After obtaining written consent, blood samples were taken from all of the patients in order to test their malondialdehyde (MDA), glutathione peroxidase (GPX), superoxide dismutase (SOD), and total antioxidant capacity (TAC). Left ventricular ejection fraction, mortality, arrhythmia and ST resolution were recorded. The data were analyzed using Pearson correlation test and t-test. Results: The mean age of patients was 60.43±10.32 years. There were no significant differences between the two groups with regard to mean age, risk factors, serum level of MDA, and TCA (P>0.05). Post MI, heart failure was significantly higher in group A (64% vs 47%, p=0.044), while difference in hospital mortality and heart arrhythmia was not significant between groups (P>0.05). Complete ST segment Resolution (STR)was observed significantly higher in group B (36% vs 17%, P=0.006). The SOD and GPX levels in group B were significantly higher compared to the other group (1547.51±328.29 vs. 1449.97±246.06, P=0.019 and 60.62±11.95 vs 57.41±10.14, P=0.042). The levels of GPX and SOD were directly related with complete STR and post PCI TIMI flow 3 in group A (p=0.002 and p<0.01, p=0.005 and p<0.02 respectively).