Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Cardiol J. 2012;19(4):381-6. doi: 10.5603/cj.2012.0069.
Cigarette smoking increases the oxidative stress mediated vascular dysfunction in young adults. We aimed to investigate the relation between the oxidative stress indices and coronary artery disease (CAD) severity in young patients presenting with acute myocardial infarction (AMI).
Young patients (aged 〈 35 years) who were admitted consecutively to our hospital with a diagnosis of AMI were included in the study. Age matched healthy subjects were selected as controls. Oxidative stress indices including lipid hydroperoxide (LOOH), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), paraoxonase (PON) and arylesterase (ARE) activities were measured in serum. CAD severity was assessed by calculating the SYNTAX (Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery Study) score. We analyzed the association between the oxidative indices and CAD severity.
Forty two young patients were admitted to the hospital with AMI (age 32.4 ± 2.6 years; 39 males, 3 females). Current and heavy smoking was commonly observed among the patients (79%). All patients underwent emergency coronary angiography. Twenty-eight healthy subjects were selected as controls. Patients had significantly higher OSI and TOS levels (median, interquartile range) [0.44 (0.26-1.75) vs 0.25 (0.22-0.30), p < 0.001 and 6.0 (4.4-20.8) vs 4.1 (3.7-4.6), p < 0.001], respectively, and lower TAS and LOOH levels [1.6 ± 0.1 vs 1.7 ± 0.1, p = 0.02 and 3.0 ± 0.8 vs 3.6 ± 0.4, p = 0.001], respectively, compared to the control group. CAD severity correlated positively with OSI (r = 0.508, p = 0.001) and TOS levels (r = 0.471, p = 0.002). Subjects with an intermediate to high SYNTAX score (≥ 22) demonstrated significantly higher OSI (median, interquartile range) [0.40 (0.34-1.75) vs 0.34 (0.26-0.68), p = 0.01] and TOS [6.9 (4.4-20.8) vs 5.8 (4.5-11.4), p = 0.01] levels compared to subjects with low SYNTAX score.
Oxidative stress is an important contributor to CAD severity among young smokers. Elevated OSI and TOS levels reflect disease severity and vascular damage related to heavy smoking in early onset CAD.
吸烟会增加年轻成年人氧化应激介导的血管功能障碍。我们旨在研究氧化应激指数与年轻急性心肌梗死（AMI）患者冠状动脉疾病（CAD）严重程度之间的关系。
连续纳入我院诊断为 AMI 的年轻患者（年龄＜35 岁）为研究对象。选择年龄匹配的健康受试者作为对照组。在血清中测量氧化应激指数，包括脂质过氧化物（LOOH）、总抗氧化状态（TAS）、总氧化状态（TOS）、氧化应激指数（OSI）、对氧磷酶（PON）和芳基酯酶（ARE）活性。通过计算 SYNTAX（经皮冠状动脉介入与心脏手术研究之间的协同作用）评分来评估 CAD 严重程度。我们分析了氧化指标与 CAD 严重程度之间的关系。
42 名年轻患者因 AMI 入院（年龄 32.4±2.6 岁；39 名男性，3 名女性）。患者中常见目前吸烟和重度吸烟（79%）。所有患者均行急诊冠状动脉造影。选择 28 名健康受试者作为对照组。患者的 OSI 和 TOS 水平显著升高（中位数，四分位距）[0.44（0.26-1.75）比 0.25（0.22-0.30），p＜0.001 和 6.0（4.4-20.8）比 4.1（3.7-4.6），p＜0.001]，而 TAS 和 LOOH 水平分别显著降低[1.6±0.1 比 1.7±0.1，p=0.02 和 3.0±0.8 比 3.6±0.4，p=0.001]，与对照组相比。CAD 严重程度与 OSI 呈正相关（r=0.508，p=0.001）和 TOS 水平（r=0.471，p=0.002）。SYNTAX 评分处于中至高（≥22）的患者 OSI（中位数，四分位距）[0.40（0.34-1.75）比 0.34（0.26-0.68），p=0.01]和 TOS [6.9（4.4-20.8）比 5.8（4.5-11.4），p=0.01]水平明显更高。
氧化应激是年轻吸烟者 CAD 严重程度的重要因素。升高的 OSI 和 TOS 水平反映了早发性 CAD 中与大量吸烟相关的疾病严重程度和血管损伤。
