Oxidative Stress and Antioxidant Defense in Acute Myocardial Infarction- A Case Control Study

Abstract

Background and Objectives: ABSTRACT Myocardial infarction is the single largest killer disease in the world. The extensive mortality and morbidity associated with coronary artery disease has stimulated the search for non invasive methods to assist the clinician in the diagnosis of myocardial infarction. Oxidative stress and altered lipid profile are the hallmarks in patients of acute myocardial infarction as observed in recent years. The objectives of the study was to compare lipid peroxidation, antioxidant status and lipid profile in patients of acute MI and controls. Methods: The present study comprises of 50 clinically diagnosed and ECG confirmed cases of acute MI admitted to the intensive cardiac care unit of KLE Society's Dr Prabhakar Kore Hospital and Research Centre, Belgaum. This study was undertaken between September 2007 to August 2008. The cases were grouped into diabetic ( 25) and hypertensives ( 25) . All the patients were in the age group of 40-60 years including both the sexes. Biochemical parameters like malondialdehyde, enzymatic antioxidants : superoxide dismutase, catalase, glutathione reductase and non enzymatic antioxidants like vitamin E, vitamin C were estimated in cases and controls. Lipid profile was also measured in healthy controls and the cases. Blood glucose and blood pressure values were also taken. xiii Results: The blood malondialdehyde ( in nmol/ml ) in controls was 6.3 ± 0.92 and 11.5 ± 0.72 in cases. The value of superoxide dismutase ( IU/g of Hb ) in controls was 940.4 ± 93.95 and 450.8 ± 116.76 in the cases. The mean glutathione reductase level ( in IU/g of Hb ) in controls was 9 ± 1.02 and 3.1 ± 0.79 in the cases. The mean catalase level ( in IU/g of Hb) in controls was 7.3 ± 0.70 and 2.6 ± 0.53 in cases. The mean level of vitamin E ( in mg/dl ) in controls was 0.92 ± 0.10 and 0.54 ± 0.14 in the cases. The mean vitamin C level ( in mg/dl ) in controls was 0.87 ± 0.09 and 0.51 ± 0.13 in the case. The mean value of total cholesterol ( in mg/dl ) in controls was 170.6 ± 21.38 and 260 ± 28.12 in the cases. The value of HDL ( in mg/dl ) in controls was 39.6 ± 4.17 and 31.1 ± 0.83 in the cases. The mean level of LDL ( in mg/dl ) in controls was 118.8 ± 27.43 and 151.3 ± 20.03 in the cases. The mean level of VLDL ( in mg/dl ) in controls was 25.5 ± 5.51 and 34.2 ± 10.54 in cases. The mean level of triglyceride ( in mg/dl ) in controls and cases was 118.4 ± 23.79 and 157.7 ± 20.21 respectively. The mean level of blood sugar ( in mg/dl ) and B.P. ( in mm of Hg ) was increased in diabetic and hypertensives with acute MI. Interpretation and conclusion: Our study revealed that there was increased oxidative stress and decreased antioxidant defense in patients of acute myocardial infarction. Altered lipid profile was also observed in the study. It is established fact that diabetic and hypertensive individuals are more prone for AMI as compared to healthy individuals. xiv Supplementation of natural antioxidants to the individuals who are prone for AMI ( i.e, diabetic and hypertensive ) may prevent the occurrence of AMI to a certain extent.