Complex Coronary Instent Chronic Total Occlusion Lesions: Oxidative Stress, Inflammation, and Coronary Stent Lengths.

Xia Li,Dianxuan Guo,Fenglin Zhang,Ying Chen,Youdong Hu,Vladimir Jakovljevic

doi:10.1155/2021/8815048

Xia Li, Dianxuan Guo + Show 4 more

Open Access

https://doi.org/10.1155/2021/8815048

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Abstract

The oxidative stress and inflammation played the key roles in the development of atherosclerotic coronary plaques. However, the relationships between pro/antioxidant, pro/anti-inflammatory status, and complex coronary instent chronic total occlusion lesions were not clear in the elderly patients with very long stent implantations. We tried to evaluate the roles of pro/antioxidant and pro/anti-inflammatory biomarkers in the diagnosis of complex reocclusion lesions in elderly patients after coronary stenting. We evaluated the expression levels of acrolein (ACR), malondialdehyde (MDA), high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), superoxide dismutase 3 (SOD3), paraoxonase-1 (PON-1), endothelial nitric oxide synthase (eNOS), and stromal cell-derived factor-1α (SDF-1α) in the elderly patients with very long stent implantations and complex reocclusion lesions. Levels of ACR, MDA, hs-CRP, and TNF-α were remarkably increased (P < 0.001), and levels of SOD3, PON-1, eNOS, and SDF-1α were decreased significantly (P < 0.001) in the elderly patients with very long stents and complex reocclusion lesions. The prooxidant and proinflammatory biomarkers were remarkably increased, as well as antioxidant and anti-inflammatory biomarkers were decreased significantly in the elderly patients with very long stent implantations and complex reocclusion lesions after coronary stenting. In conclusion, these findings indicated that the imbalance between prooxidant/proinflammatory and antioxidant/anti-inflammatory status was associated with complex reocclusion lesions, suggesting that oxidative stress and inflammation played the key roles in progression of complex reocclusion lesions in the elderly patients with very long stent implantations.

Highlights

The findings show that acrolein (ACR) has the oxidative, proinflammatory, and atherogenic effects
The levels of superoxide dismutase 3 (SOD3), PON-1, endothelial nitric oxide synthase (eNOS), and stromal cell-derived factor-1α (SDF-1α) were reduced remarkably in the reocclusion length 21-35 mm group when compared with the reocclusion length 11-20 mm group and reocclusion length 4-10 mm group, respectively (P < 0:001) and were further reduced remarkably in the reocclusion length 36-47 mm group compared to the reocclusion length 21-35 mm group and reocclusion length 11-20 mm group, respectively (P < 0:001)
These findings suggested that high levels of ACR, MDA, high sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor-α (TNF-α) and low levels of SOD3, PON-1, eNOS, and SDF-1α were associated with reocclusion lengths in the elderly patients with very long stent implantations

Summary

Introduction

The findings show that acrolein (ACR) has the oxidative, proinflammatory, and atherogenic effects. ACR is a key oxidative stress biomarker and leads to the increase in oxidative cellular damage through an inflammatory response, and ACR levels are increased in coronary atherosclerosis and myocardial infarction. ACR elevates the levels of tumor necrosis factor-α (TNF-α) in endothelial cells and plays a key role in coronary atherosclerosis [1]. The increased malondialdehyde-modified low-density lipoprotein (MDALDL) is detected in the plasma of patients with acute coronary syndrome, and MDA-LDL plays an important role in the initiation and progression of coronary atherosclerosis. The increased MDA-LDL is related to endothelial damage and coronary plaque instability in the patients with coronary heart disease [2].

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