Relationship Between Red Cell Distribution Width and Oxidative Stress Indexes in Patients with Coronary Artery Disease.

Background: Red blood cell distribution (RDW), an index of the size variability of erythrocytes, is significantly associated with coronary stenosis and can strongly predict the mortality risk in coronary artery disease (CAD). The biological mechanisms involved are not fully understood but may include oxidative stress. We sought to investigate the relationship between RDW and markers of oxidative stress in patients with CAD. Methods: Participants were 112 consecutive patients referred to department of cardiac surgery for evaluation of chest pain. 32 patients had stable CAD, 40 patients had unstable CAD and 40 subjects were diagnosed as non-CAD. The levels of lipid peroxidation (TBARS) were measured in plasma and membrane samples by a fluorometric method. The plasma levels of glutathione (GSH) and total antioxidant capacity (TAC) were determined using spectrophotometric methods. Results: Lipid peroxidation levels were significantly higher in the erythrocyte membrane of stable CAD patients than non-CAD patients. The levels of TAC were significantly lower in both stable and unstable groups when compared to that of the control group (P< 0.019 and P< 0.001, respectively), but did not differ between stable and unstable CAD. In addition, there was no significant difference in the serum GSH levels among the study groups. Membrane TBARS was directly associated with RDW in three groups of study. Conclusions: We found an independent association between RDW levels and membrane lipid peroxidation in patients with CAD. This finding suggests that oxidative stress may be a potential underlying biological mechanism for increased RDW in CAD patients.

Association of the serum apelin, but not ghrelin, with the presence and severity of coronary artery disease.

Increasing evidence suggests that apelin and ghrelin may participate in atherogenesis. We sought to investigate whether the serum levels of apelin and ghrelin are significantly different in patients with coronary artery disease (CAD) compared to patients with nonsignificant coronary stenosis and determine the correlation between these adipokines and the severity of coronary stenosis. The study population included 31 stable CAD patients, 38 unstable CAD patients, and 39 non-CAD subjects. Serum levels of apelin and ghrelin, fasting blood glucose, lipid parameters, hs-CRP and hematological indices were determined in all groups using routine standard laboratory procedures. Serum apelin levels were significantly lower in patient with unstable CAD (0.354 ± 0.063 ng/mL) compared to stable CAD patients (0.401 ± 0.045 ng/mL, p = 0.003) and non-CAD subjects (0.415 ± 0.055 ng/mL, p<0.001). In addition, serum apelin levels were inversely correlated with the severity of coronary stenosis in CAD patients (p<0.05). However, there was no significant difference in ghrelin levels among the 3 groups. This data may suggest that the presence of unstable CAD may be associated with lower serum apelin which may indicate the potential role of this peptide in the progression and destabilization of coronary plaques.

Decreased Na+/K+-ATPase Activity and Altered Susceptibility to Peroxidation and Lipid Composition in the Erythrocytes of Metabolic Syndrome Patients with Coronary Artery Disease.

BACKGROUND: The increased generation of reactive oxygen species that occurs in the case of a metabolic syndrome (MetS) may be responsible for the increased oxidative injury to erythrocyte membranes in coronary artery disease (CAD). Therefore, we studied the effects of MetS on both indexes of oxidative damage and biochemical properties of erythrocyte membranes in CAD patients. METHODS: We analyzed the markers of oxidative stress, Na+/K+-ATPase activity, total cholesterol content of erythrocyte membranes (CEM), and fatty acid compositions of the erythrocyte membrane in 82 patients with stable CAD and 39 non-CAD subjects. RESULTS: The CAD patients had higher levels of CEM, membrane lipid peroxidation, erythrocyte superoxide dismutase (SOD) activity, and Na+/K+-ATPase activity compared with non-CAD subjects. The Na+/K+-ATPase activity was correlated negatively with membrane lipid peroxidation, and positively with the CEM. In CAD patients with MetS compared with those without MetS, we found that the membrane lipid peroxidation and CEM were increased, whereas the n-3 fatty acids content, SOD activity, Na+/K+-ATPase activity were decreased. CONCLUSION: These findings suggest an impairment of erythrocyte membrane biochemical properties in stable CAD patients as a consequence of oxidative injury that may contribute to the development of CAD. In addition, MetS may be related to increased oxidative injury to erythrocyte membranes.

Investigation of membrane fatty acid profiles in erythrocytes of patients with stable coronary artery disease.

BACKGROUND: The association between the erythrocyte membrane fatty acids and the severity of coronary stenosis has not been studied in patients with stable coronary artery disease (CAD). OBJECTIVE: We sought to investigate whether the fatty acid profile of erythrocyte membranes is significantly different in patients with stable CAD compared with patients with nonsignificant coronary stenosis and evaluate a possible relationship between fatty acid profile and the severity of coronary stenosis. METHODS: The population included 144 patients, undergoing clinically indicated coronary angiography. The severity of coronary stenosis was scored after coronary angiography, and patients were divided into 2 groups; the S-stenosis group (CAD patients, n = 82) had a significant stenosis indicated by coronary angiography and the second group, S-stenosis (n = 62), had nonsignificant coronary stenosis. RESULTS: The erythrocyte membranes linoleic acid (LA) levels were lower (P < .001) and the arachidonic acid (AA)-to-LA ratio, a marker of desaturase activity, were higher (P < .001) in CAD patients compared with S-stenosis patients. The CAD scores were correlated negatively with the membrane LA levels (r = -0.338; P < .001) and positively with the AA-to-LA ratio (r = 0.306; P < .001). CONCLUSIONS: This study shows that LA levels of the erythrocyte membrane and AA-to-LA ratio are correlated with the severity of CAD.

Association of the total cholesterol content of erythrocyte membranes with the severity of disease in stable coronary artery disease.

Increasing evidence suggests that erythrocytes may participate in atherogenesis. We sought to investigate whether the total cholesterol content of erythrocyte membranes (CEM) is significantly different in patients with stable coronary artery disease (CAD) compared to patients with nonsignificant coronary stenosis and determine the correlation between CEM and the severity of coronary stenosis. Methods. The population included 144 patients, undergoing clinically indicated coronary angiography. The severity of coronary stenosis was scored after coronary angiography and patients were divided into two groups; the S-stenosis group (CAD patients, n = 82) had a significant stenosis indicated by coronary angiography and the second group, N-stenosis (n = 62), had nonsignificant coronary stenosis. Lipid parameters were determined by routine laboratory methods. CEM was measured using an enzymatic assay, and protein content was assessed by the modified Lowry method. Results. The mean of CEM levels was higher (P < 0.001) in stable CAD patients (137.2 µg/mg of membrane protein) compared with N-stenosis patients (110.0 µg/mg of membrane protein). The coronary artery scores were correlated positively with CEM levels (r = 0.296, P < 0.001). Conclusion. CEM levels are positively associated with the severity of CAD, meaning that CEM might contribute to the development of CAD.