Association of coronary artery disease severity and disulphide/native ...

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Yıldırım Beyazıt University School of Medicine, Department of Biochemistry, Ankara, ... Bulent Bilir1, Dursun Cayan Akkoyun2, Murat Aydın3, Demet Ozkaramanlı ...
Eur J Gen Med 2017;14(2):30-33 ISSN:1304-3889 eISSN:1304-3897 DOI: 10.29333/ejgm/81878

Original Article

Association of coronary artery disease severity and disulphide/native thiol ratio Bulent Bilir1, Dursun Cayan Akkoyun2, Murat Aydın3, Demet Ozkaramanlı Gur2, Hasan Degirmenci4, Neslihan Albayrak4, Aydın Akyuz2, Seref Alpsoy2, Cemile Koca5, Ozcan Erel5 ABSTRACT Objective: Oxidative stress is among the major components of cardiovascular disease pathogenesis. Thiols play a significant role in prevention of oxidative stress in the cell. The purpose of this study is to investigate the relationship between the severity of coronary artery disease and disulphide/native thiol ratio, also determine if this ratio can be used as a marker of oxidative stress in this population. Methods: A total number of 107 patients with angiographically established coronary artery disease and 26 control subjects with normal coronary arteries were enrolled. The mean Gensini score of patients were calculated (mean=30) and a score of 29 or below was considered as mild and a score of 30 or higher coronary artery disease as severe. Serum total, native thiol was measured and the disulphide and disulphide/native thiol ratio were calculated as described by Erel&Neselioglu. Results: Patients with mild and severe coronary artery disease had significantly lower native thiol levels and higher disulphide/native thiol ratio levels when compared to the control subjects. Also severe disease’s disulphide/native thiol ratio were higher than mild. Conclusion: The increased disulphide/native thiol ratio related with the severity of coronary artery disease, may reflect the augmented oxidative stress in coronary artery disease.

Keywords: coronary artery disease, disulphide/native thiol ratio, oxidative stress INTRODUCTION Cardiovascular disease (CVD) is the major cause of morbidity and mortality in the world with increasing incidence in recent years. The half of the mortality from cardiovascular diseases mainly arises from coronary artery disease (CAD) (1, 2). The pathogenesis of CAD includes endothelial dysfunction, inflammation, oxidative stress and vascular calcification which together lead to plaque formation with eventual rupture, ending up with a cardiovascular event (3, 4). Oxidative stress is a phenomenon that occurs when cell’s antioxidant capacity is overwhelmed by the accumulated reactive oxygen species (ROS) in the cell (5). Current literature clearly describes the relationship between oxidative stress and CAD, and therefore exercise and diet have been suggested to combat oxidative stress. Moreover, reduction of oxidative stress with antioxidant agents may help in prevention and/or management of CVD (6). Thiols, the organic compounds containing sulfhydryl group (–SH) groups, play a significant role in prevention of oxidative stress in the cell. The thiol groups, which are found in the amino acid components of proteins, get oxidized by free radicals forming reversible disulphide bonds. This represents the initial step of protein oxidation which opposes the harmful effects of ROS. The disulphide bonds can be reduced to thiol groups with the aid of various antioxidants to maintain an equilibrium in both directions (7). Disuphide/native thiol Ratio (DTR) is a novel marker that is used as a measure of thiol and disulphide homeostasis. An increased DTR is shown to participate in the pathogenesis of CVD, diabetes, cancer and renal insufficiency (8). 1 2 3 4 5

Namik Kemal University School of Medicine, Department of Internal Medicine, Tekirdag, Turkey. Namik Kemal University School of Medicine, Department of Cardiology, Tekirdag, Turkey. Namik Kemal University School of Medicine, Department of Department of Biochemistry, Tekirdag, Turkey. Republic of Turkey Ministry of Health, State Hospital, Clinic of Cardiology, Tekirdag, Turkey. Yıldırım Beyazıt University School of Medicine, Department of Biochemistry, Ankara, Turkey.

Received: 19 Feb 2016, Accepted: 3 Oct 2016

European Journal of General Medicine

Coronary artery disease is a chronic disease that begins years before a cardiovascular event. Thus, identification of the risk is of paramount importance for the primary prevention of CVD. Despite efforts to perform an early diagnosis and to stop the progression of CVD, currently there is no effective method. Therefore, novel reliable markers and methods are necessary for early detection of CVD in order to control the progression of disease. As a novel marker of oxidative stress, DTR is evaluated in several diseases. To the best of our knowledge, this is the first study to evaluate DTR in CAD patients. Since DTR is a novel, noninvasive and easy method, this study purposed to reveal the relationship between DTR and CAD severity determined by Gensini score. Therefore, we aimed to explore the utility of DTR as a marker of oxidative stress in this population. MATERIALS AND METHODS Ethical Permission The present study was approved by the local Ethics Committee of Namik Kemal University. The study complied with the Declaration of Helsinki and informed consent was obtained from all groups. Study Design, Eligibility Criteria, and Analyses In this study 133 consecutive patients (82 men and 51 women) with stable angina pectoris who underwent coronary angiography for suspected CAD at Namik Kemal University Faculty of Medicine were enrolled. The exclusion criteria included the following; presence of acute coronary syndromes, Correspondence: Bulent Bilir Namik Kemal University School of Medicine, Department of Internal Medicine, Tekirdag, Turkey. E-mail: [email protected]

Figure 1: Inter-group comparisons of DTR, disulphide and native thiol measurements pregnancy, hypertension, type 1 or type 2 diabetes mellitus, malignancy, systemic diseases, acute or chronic inflammation. Located in patients group and healthy controls serum fasting glucose, cholesterol measuring the levels, created the standard form was recorded. This form of arterial blood pressure, demographic data from patients and pharmacological agents used were added. Data of these patients were collected. Three interventional cardiologists blinded to the clinical data of the patients, calculated the Gensini scores which is used as a measure of severity of the CAD. There was no inconsistency between the interventional cardiologists who evaluated the Gensini score. The subjects were categorized into three groups; patients with severe CAD (Gensini score ≥ 30), patients with mild CAD (Gensini score