Effect of percutaneous transluminal coronary angioplasty on oxidants and antioxidants in patients with coronary artery disease

Percutaneous transluminal coronary angioplasty (PTCA) has become a common intervention in coronary artery disease (CAD), relieving symptoms such as angina and improving myocardial function. There is short term injury to the heart after PTCA; which can take in the form of reperfusion arrhythmias or myocardial stunning or both. Production of oxygen derived free radical potentially cytotoxic species which can be formed may be controlled by naturally occurring antioxidant defence. In this study we investigated the alterations in oxidative and antioxidative status after PTCA by estimating Malondialdehyde (MDA) as marker of oxidative stress, Superoxide Dismutase (SOD) and vitamin C for antioxidant status and myocardial cell damage by Creatine Phosphokinase total (Cpk-total) and Creatine Phosphokinase-MB (Cpk-MB).

120 patients of CAD, subjected to PTCA were included in the study. MDA, SOD, Vitamin C, Cpk total and Cpk-MB levels were measured after PTCA in patents.

There were increased levels of SOD & Cpk-total, 4.94 ± 0. Units/ml & 119.46 ± 40.51 U/L, (p < 0.001), respectively, in patients after PTCA. SOD & Cpk-total are statistically highly significant. MDA was 6.01 ± 1.22 nmole/ml, considerably decreased & it is statistically significant (p < 0.001). Vitamin C & Cpk-MB were 0.88 ± 0.32 mg/dl & 13.62 ± 6.17 U/L (p > 0.05), borderline increased. They are statistically insignificant.

These findings suggest that cardial lipo peroxidation may be common event following brief episodes of myocardial ischemia and support a role for antioxidant therapy in patients after PTCA.