Dinamica de durată a markerilor stresului oxidativ la pacienţii cu restenoză intra-stent după revascularizarea repetată ţintă

Abstract

Background: The oxidative stress as a key mechanism of vascular injury and remodeling represents an important subject of in-stent restenosis (ISR) pathogenesis study. Material and methods: This article is aimed at the evaluation of the circulating levels of oxidative stress markers in 68 patients with ISR, which are the following: malonic dialdehyde (MDA) advanced oxidized protein products (AOPP), glutathione peroxidase, glutathione reductase, catalase, superoxide dismutase, total antioxidant activity (TAA), advanced glycation end products (AGEPs) and arginase. These markers were assayed before the repetitive target revascularization and after 1, 3, 6 and 12 months (40 healthy persons served as a control group). Results: The obtained outcomes indicate that the oxidative stress activity has been markedly increased in the patients with ISR and has remained raised after the revascularization what has been demonstrated by significantly increased MDA and AOPP levels compared to the control markers during all study period. Antioxidant enzymes have been decreased in restenosis, and the most conspicuous reduction has been found for TAA – by 56%. After the revascularization this marker practically has not been changed. The levels of AGEPs and arginase have had a similar dynamics whose main trait has been their rise by 20-28% after 3 months compared to pre-conditioning indices. The pathophysiological significance of the period concerning implication of both factors in free oxygen radicals release and endothelium dysfunction cannot be overestimated. Conclusions: The results confirm the pathogenetic role of oxidative stress in the in-stent restenosis evolution, whose activity assay in practice may be supported by MDA, AOPP, TAA, AGEPs and arginase circulating levels estimation.