Journal of Clinical and Diagnostic Research (Nov 2021)
Oxidant-antioxidant Status Discrepancy between Patients with ST Segment Elevation and Non ST Segment Elevation Myocardial Infarction: A Case-Control Study
Abstract
Introduction: Depending on the degree of coronary artery occlusion and the damage to the myocardium, two types of myocardial infarction can be distinguished: non ST Elevation Myocardial Infarction {NSTEMI type (without ST segment elevation)} and ST Elevation Myocardial Infarction {STEMI type (with ST segment elevation)}. Consequently, this may lead to diverse levels of Reactive Oxygen Species (ROS) and dissimilar oxidative profile between the two conditions. Aim: To assess the oxidant-antioxidant status in STEMI versus NSTEMI patients and healthy controls. Materials and Methods: This case-control study was carried out from September 2018 to March 2019. A total of 67 Acute Myocardial Infarction (AMI) patients, categorized into two groups: those with STEMI (Group 1) and those with NSTEMI (Group 2), were enrolled into the study, and were compared with 75 healthy controls. Oxidant-antioxidant markers, lipid profile and uric acid were quantified for all participants. Statistical comparison between all groups was performed by one-way Analysis of Variance (ANOVA) test followed by Tukey post-hoc test. Results: The findings showed a significant increase in the level of oxidative markers as determined by serum Malondialdehyde (MDA), Carbonyl Proteins (CP), Nitric Oxide (NO•) and superoxide radicals (p-value<0.001) in AMI patients particularly in those with STEMI. Concomitantly, there was a notable decrease in the level of antioxidants such as Glutathione (GSH) and catalase (p-value<0.001). A noteworthy raise was also noticed in the serum uric acid concentration in patients with AMI as compared to healthy subjects. However, no statistically significant difference between the two cases groups was revealed. Conclusion: The magnitude of imbalance between oxidant and antioxidant markers is greater in STEMI patients, most likely because of the expanse of myocardial necrosis and superior occlusion of their coronary arteries.
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