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Role of pre-procedural glutathione concentrations in the prediction of major adverse cardiac events (MACE) in patients with acute coronary syndrome treated with percutaneous coronary intervention.
MedLine Citation:
PMID:  23612023     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION Poor antioxidant protection due to cardiac ischemia and low reduced glutathione (GSH) in blood serum may associate with enhanced risk of coronary restenosis after primary percutaneous coronary intervention (pPCI). OBJECTIVES The aim was to investigate whether pre-procedural serum GSH, reflecting antioxidant status, may be predictive of major adverse cardiac events (MACE) in patients with acute coronary syndrome (ACS) treated with pPCI.  PATIENTS AND METHODS Pre-procedural serum GSH was evaluated in 141 ACS patients treated with pPCI with bare metal stent (BMS) deployment. During 15-month follow-up 30 patients (M/F: 19/11; 61 ± 10 yr) experienced MACE, contrary to the non-MACE group (N=111, M/F:80/31; 63± 10 yr). RESULTS MACE patients showed significantly reduced pre-procedural GSH compared to the non-MACE group (p<0.001); this occurred also in diabetic individuals (p<0.001) but not in non-diabetic patients. All patients were arbitrarily classified as having low (< median: 1.39; 1.04-1.55 mmol/l) or high serum GSH (> median: 2.26; 2.09-2.99 mmol/l; p<0.001). Kaplan-Meier estimates of MACE-free survival rate were higher in the carriers of higher serum GSH (p<0.004). Cox proportional hazard regression, which controlled for the history of myocardial infarction and diabetes, indicated that patients with lower GSH were 2.2 times more likely to experience MACE than those with high GSH (95% CI = 1.2-3.9; p<0.02 in a whole group and 1.8-11.8 for patients with diabetes; p<0.002). CONCLUSIONS Pre-procedural GSH may be useful in MACE prediction in patients with ACS treated with pPCI with BMS deployment, especially in diabetic subjects.
Authors:
Robert Pietruszyński; Leszek Markuszewski; Konrad Masiarek; Marcin Makowski; Weronika Retelewska; Cezary Watala
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-4-24
Journal Detail:
Title:  Polskie Archiwum Medycyny Wewnetrznej     Volume:  -     ISSN:  1897-9483     ISO Abbreviation:  Pol. Arch. Med. Wewn.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-4-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401225     Medline TA:  Pol Arch Med Wewn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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