Abstract
SummaryBackgroundOxysterols have been shown to play a role in plaque formation while ischemia modified albumin (IMA) is widely accepted as an acute marker for ischemia. The effort test is one of the methods used to identify the presence of coronary artery disease. Thus, there may be a relationship between effort test result and the levels of IMA, 7-ketocholesterol (7-KC) and cholestane-3β,5α,6β-triol (C-triol).MethodsThirty patients who underwent effort test and 30 healthy subjects were included in the study. IMA levels were determined with the albumin-cobalt binding test, 7-KC and C-triol levels were determined with LC-MS/MS. Among the patients, two subgroups were identified according to the results of the effort test, group 1 consisted of patients with a positive effort test (n = 12), and group 2 consisted of patients who had a negative effort test (n = 18).Results7-KC levels of patients were significantly higher compared to healthy subjects (39.87 ± 2.13 ng/mL, 20.26 ± 1.35 ng/mL; p=0.001). In patients, post-test 7-KC levels were significantly lower than pre-test levels (post-test vs. pre-test: 37.73 ± 2.44 ng/mL vs. 41.07 ± 2.18 ng/mL; p<0.001). There was a significant difference in post-test 7-KC levels among all study groups (negative, positive and healthy: 37.73 ± 2.44 ng/mL, 39.87 ± 2.13 ng/mL, 20.26 ± 1.35 ng/mL, respectively). There was no significant difference in IMA levels.ConclusionsPatients with positive effort test had significantly higher levels of 7-KC. Additionally, after the effort test, the 7-KC value was reduced. 7-KC is a biomarker of oxidative damage and its value or changes before and after the effort test may be used as a biomarker in the diagnosis and follow-up of coronary artery disease.
Highlights
Coronary artery disease (CAD) is the most common cause of death worldwide and it manifests with chest pain [1]
In order to identify if chest pain is due to CAD, tests such as exercise stress test, CT angiography, myocardial perfusion scintigraphy and direct conventional angiography are utilized [2, 3]
Oxysterols have been implicated in the formation and progression of atherosclerotic plaques [6, 7]. 7-ketocholesterol (7-KC), 7ß-hydroxycholesterol (7ß-OHC), beta-isomers of epoxide, 27-hydroxycholesterol (27OHC) and cholestane-3b,5a,6b-triol (C-triol) have been shown to increase in plasma and/or atherosclerotic plaque in various studies (8 –12). 7-KC occurs via the reaction of peroxyl and alkoxyl radicals and the Russell mechanism, and can be converted from 7b-OHC by the enzyme 11b-hydroxysteroid dehydrogenase [13, 14]
Summary
Coronary artery disease (CAD) is the most common cause of death worldwide and it manifests with chest pain [1]. Chest pain has many other causes besides CAD. In order to identify if chest pain is due to CAD, tests such as exercise stress test, CT angiography, myocardial perfusion scintigraphy and direct conventional angiography are utilized [2, 3]. Oxysterols have been implicated in the formation and progression of atherosclerotic plaques [6, 7]. 7-ketocholesterol (7-KC), 7ß-hydroxycholesterol (7ß-OHC), beta-isomers of epoxide, 27-hydroxycholesterol (27OHC) and cholestane-3b,5a,6b-triol (C-triol) have been shown to increase in plasma and/or atherosclerotic plaque in various studies (8 –12). Epoxy-cholesterols, which are formed by peroxyl radicals via the reaction of lipid hydroperoxides with cholesterol, are transformed to C-triol. The measurement of 7-KC together with C-triol should be sufficient in showing oxidative stress and could be assumed to be the best biomarkers among oxysterols [15, 16]
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