The importance of thiol / disulfide homeostasisand ischemia-modified albumin levels in acute coronary syndrome and their relationship with angiographic scoring systems

Abstract

Objective: The objective of this study was to investigate the differences in thiol/disulfide homeostasis- and ischemia-modified albumin (IMA) levels that are known to be associated with oxidative damage in patients with acute coronary syndrome between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction/unstable angina pectoris (NSTEMI/USAP) groups and their relationships with angiographic scoring systems. Methods: A total of 142 patients were included in this study, with 49 in group 1 (STEMI) and 93 in group 2 (NSTEMI/USAP). Thiol/disulfide homeostasis was determined using a recently developed novel method. We investigated whether thiol/disulfide homeostasis and parameters such as IMA, troponin I, and creatine kinase MB fraction levels were associated with Gensini, and Syntax I and II scores, which are angiographic scoring systems. Results: The native and total thiol levels were found to be statistically significantly lower in the STEMI group than in the NSTEMI/ USAP group (both, p < 0.05). The serum IMA levels were statistically significantly higher in group 1 (0.59±0.12 vs 0.46±0.23 absorbance units, p<0.05). A significant positive correlation was found between the IMA and peak troponin I levels. Conclusion: Thiol/disulfide homeostasis was shifted in favor of disulfide in the STEMI group, indicating a significant correlation between increased myocardial damage and disulfide. Similarly, the significantly higher IMA levels and positive correlation between IMA and peak troponin I in the STEMI group indicate its vulnerability in the infarcted myocardium area in addition to its vulnerability known in ischemia.