Clinical value of anti-oxidative stress biomarkers for diagnosing in-stent restenosis and in-stent reocclusion after coronary stent implantation in advanced-aged patients

Abstract

Objective To study the clinical value of anti-oxidative stress biomarkers for diagnosing in-stent restenosis and in-reocclusion after coronary stent implantation in aged patients. Methods A total of 72 advanced-aged patients with in-stent restenosis and in-stent reocclusion after coronary stent implantation were successively recruited in this retrospective study from February 2010 to November 2017.Changes in serum superoxide dismutase 3(SOD3), nitric oxide(NO), endothelial cell nitric oxide synthase(eNOS)and malondialdehyde(MDA)levels were measured. Results Serum 1evels of SOD3, NO and eNOS decreased and serum MDA levels were elevated in advanced-aged patients with in-stent restenosis.There were significant differences in serum levels of SOD3, NO, eNOS and MDA between the advanced-aged patients without in-stent restenosis and the advanced-aged patients with multivessel in-stent restenosis or reocclusion[(20.0±3.2)×103U/L vs.(10.9±3.9)×103U/L, (61.2±14.2)μmol/L vs.(28.3±17.2)μmol/L, (75.9±24.7)ng/L vs.(33.0±19.6)ng/L, (2.2±1.4)nmol/L vs.(11.7±3.1)nmol/L, respectively, P<0.01]. Patients with 50-69% restenosis had higher serum levels of SOD3, NO and eNOS and lower levels of MDA than patients with 100% restenosis[(21.3±2.9)×103U/L vs.(10.3±4.0)×103U/L, (59.7±16.7)μmol/L vs.(38.3±16.3)μmol/L, (74.5±21.1)ng/L vs.(41.9±26.8)ng/L, (2.6±3.9 nmol/L)vs.(10.1±3.1)nmol/L, respectively, P<0.01]. Patients with left ventricular ejection fraction(LVEF)≥55% had higher serum levels of SOD3, NO and eNOS and lower levels of MDA than patients with LVEF<30%[(21.0±4.1)×103U/L vs.(5.3±1.9)×103U/L, (60.1±14.2)μmol/L vs.(29.0±13.2)μmol/L, (74.7±25.1)ng/L vs.(39.3±20.3)ng/L, (2.3±1.5)nmol/L vs.(10.0±3.9)nmol/L, respectively, P<0.01]. Serum levels of SOD3, NO and eNOS were higher and MDA levels were lower in patients with New York Heart Association(NYHA)Class I than in patients with NYHA Class IV[(22.1±3.5)×103U/L vs.(9.7±2.9)×103U/L, (62.9±13.9)μmol/L vs.(24.9±13.3)μmol/L, (76.7±26.7)ng/L vs.(41.9±21.5)ng/L, (2.7±1.9)nmol/L vs.(8.7±3.8)nmol/L, respectively, P<0.01]. Conclusions Serum level changes of anti-oxidative stress biomarkers such as SOD3, NO and eNOS may have clinical value in diagnosing in-stent restenosis and in-reocclusion after coronary stent implantation in aged patients. Key words: Coronary restenosis; Superoxide dismutase; Nitric oxide Synthase