Karakayali Muammer, Ogun Metin, Artac Inanç, Ilis Doğan, Arslan Ayca, Omar Timor, Demir Öztürk, Karahan Talha, Kina Soner, Rencuzogullari Ibrahim, Karabag Yavuz
Departments of Cardiology.
Biochemistry.
Coron Artery Dis. 2025 May 1;36(3):211-217. doi: 10.1097/MCA.0000000000001469. Epub 2024 Dec 3.
Malondialdehyde (MDA) is a predictive marker of cardiovascular events in patients with stable angina pectoris. However, there is limited information available regarding this marker in patients with acute coronary syndrome (ACS). The aim of the study was to explore the association of MDA levels with inhospital mortality among patients with ACS.
The study sample consisted of 556 ACS patients. The leftover plasma samples collected in EDTA vials for troponin T estimation within 24 h of chest pain were used for analysis. Blood samples were collected into tubes for MDA, nitric oxide (NO), inducible nitric oxide synthase (i-NOS), endothelial nitric oxide synthase (e-NOS), total sialic acid (TSA), NT-proBNP, ANP, homocysteine, and cardiac troponin I (cTnI). The blood samples were centrifuged (4000 g , 4 °C) for 10 min, and the obtained serum then kept at -25 °C until the analyses were carried out. The relationship between these markers and inhospital mortality of ACS patients was investigated.
Univariate logistic regression analysis revealed significant correlations among sex, age, creatine, MDA, NT-proBNP, ANP, homocysteine, cTnI, NO, e-NOS, i-NOS, and TSA. Further analysis of these variables using the multivariate logistic regression analysis indicated that age, creatine, MDA, and NT-proBNP were independent predictors. Optimal MDA cutoff value of >33.1 predicted inhospital mortality with 85% sensitivity and 88.17% specificity [AUC: 0.905 (95% CI: 0.878-0.928, P < 0.001)].
We demonstrated that MDA levels were elevated in cases of inhospital mortality among ACS patients and the optimal MDA cutoff value of >33.1 predicted inhospital mortality with 85% sensitivity and 88.17% specificity.
丙二醛（MDA）是稳定型心绞痛患者心血管事件的预测标志物。然而，关于急性冠状动脉综合征（ACS）患者中该标志物的信息有限。本研究的目的是探讨ACS患者中MDA水平与住院死亡率之间的关联。
研究样本包括556例ACS患者。胸痛发作24小时内收集于乙二胺四乙酸（EDTA）管中用于肌钙蛋白T测定的剩余血浆样本用于分析。采集血液样本用于检测MDA、一氧化氮（NO）、诱导型一氧化氮合酶（i-NOS）、内皮型一氧化氮合酶（e-NOS）、总唾液酸（TSA）、N末端脑钠肽前体（NT-proBNP）、心房钠尿肽（ANP）、同型半胱氨酸和心肌肌钙蛋白I（cTnI）。血液样本在4℃下以4000g离心10分钟，所得血清保存在-25℃直至进行分析。研究了这些标志物与ACS患者住院死亡率之间的关系。
单因素逻辑回归分析显示性别、年龄、肌酸、MDA、NT-proBNP、ANP、同型半胱氨酸、cTnI、NO、e-NOS、i-NOS和TSA之间存在显著相关性。使用多因素逻辑回归分析对这些变量进行进一步分析表明，年龄、肌酸、MDA和NT-proBNP是独立预测因素。MDA最佳截断值>33.1预测住院死亡率的灵敏度为85%，特异度为88.17%[曲线下面积（AUC）：0.905（95%置信区间：0.878 - 0.928，P<0.001）]。
我们证明ACS患者住院死亡病例中MDA水平升高，MDA最佳截断值>33.1预测住院死亡率的灵敏度为85%，特异度为88.17%。
