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ECPB 2013, 62(2): 45–49
Clinical physiology and biochemistry

Oxidative stress and antioxidant protection system in patients with acute coronary syndrome, combined with diabetes mellitus type 2

BULAK O.
Abstract

The article analyzed the changes of antioxidant protection system and systems of lipid peroxidation in patients with acute coronary syndrome combined with diabetes mellitus type 2.

One of the most probable pathogenetic mechanism of acute coronary syndrome is a change in the ratio of antioxidative and prooxidative systems toward dominance last.

During this process oxidative stress develops that launches or intensifies reaction of atherogenesis and thrombosis. In combination of acute coronary syndrome with diabetes mellitus type 2 worsening oxygenation of tissues occurs, resulting from increased formation of oxidation products of free radicals. Hyperglycemia in patients with diabetes mellitus type 2 reduces the antioxidant defenses and provokes excessive formation of free radicals by glycosylation of antioxidant enzymes.

The aim of the study was to compare degree of expression of oxidative stress and antioxidant defense in patients with acute coronary syndrome, combined with diabetes mellitus type 2 and without diabetes mellitus type 2 at the beginning and in the dynamics of the disease.

118 patients with acute coronary syndrome were studied, including 59 men (54,63%) and 49 women (45,37%), average age was 56±4,7 years. Patients were divided into 4 groups: 1st group – with unstable angina and non-ST-segment elevation acute myocardial infarction combined with diabetes mellitus type 2 (44 persons (37,28%)), including 20 men (44,11%) and 24 women (55,89%), 2nd group – with ST-segment elevation acute myocardial infarction, combined with diabetes mellitus type 2 (36 persons (30,51%)) – 16 men (45,16%) and 20 women (54,84%), 3rd group – with unstable angina and non-ST-segment elevation acute myocardial infarction without diabetes mellitus type 2 (18 persons (15,25%)), including 10 men (55,55%) and 8 women (44,45%), and 4th group – with ST-segment elevation acute myocardial infarction without diabetes mellitus type 2 (20 persons (16,95%)) – 11 men (55%) and 9 women (45%).

The degree of severity of antioxidant protection was lower in patients with acute coronary syndrome combined with diabetes mellitus type 2, both at admission and on the 10th day of the disease, unlike patients with acute coronary syndrome without diabetes mellitus type 2. This conclusion was based on the data about decrease ceruloplasmin in serum, especially in the group with ST-segment elevation acute myocardial infarction, combined with diabetes mellitus type 2, where the difference on the 10th day reached 65,6% (p<0,05), compared with a similar group, but without diabetes mellitus type 2.

In patients with acute coronary syndrome combined with diabetes mellitus type 2 oxidative stress was increased, as evidenced by the more intensive accumulation of malonic dialdehyde in serum during development and the further course of the disease compared with the groups of acute coronary syndrome without diabetes mellitus type 2. These results were evidenced by the difference in the levels of malonic dialdehyde between groups of ST-segment elevation acute myocardial infarction from 22% (p<0,05) on the first day, to 13,95% (p<0,05) on the 10th day, and between groups with unstable angina and non-ST-segment elevation acute myocardial infarction from 8,33% (p>0,05) on the first day, to 15,9% (p<0,05) on the 10th day, depending on the presence of diabetes mellitus type 2.

Keywords: acute coronary syndrome, diabetes mellitus type 2, ceruloplasmin, malonic dialdehyde

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