Oxidative Stress Markers in Hypertrophic Cardiomyopathy.

Background and Objectives: Hypertrophic cardiomyopathy (HCM) depends on the primary impairment of sarcomeres, but it can also be associated with secondary alterations in the heart related to oxidative stress. The present study aimed to examine oxidative-antioxidant disturbances in patients with HCM compared with control individuals. Materials and Methods: We enrolled 52 consecutive HCM patients and 97 controls without HCM. The groups were matched for age, body mass index, and sex. Peripheral blood was collected from all patients to determine the total antioxidant capacity (TAC), total oxidant status (TOS), lipid hydroperoxide (LPH), and malondialdehyde (MDA). The oxidative stress index (OSI) was defined as the ratio of the TOS level to the TAC level. Results: The median age was 52 years, and 58.4% were female. The area under the curve (AUC) indicated good predictive power for the TAC and TOS [AUC 0.77 (0.69-0.84) and 0.83 (0.76-0.90), respectively], as well as excellent predictive power for the OSI [AUC 0.87 (0.81-0.93)] for HCM detection. Lipid peroxidation markers also demonstrated good predictive power to detect HCM patients [AUCLPH = 0.73, AUCMDA = 0.79]. Conclusions: The TOS, the TAC, LPH levels, and MDA levels have good predictive power for HCM detection. The holistic assessment of oxidative stress by the OSI had excellent power and could identify patients with HCM.

Patients with no significant lesions in coronary arteries and ST-segment elevation myocardial infarction have worse outcome than patients with non-ST-segment elevation myocardial infarction: analysis from PL-ACS Registry.

BACKGROUND: Acute myocardial infarction (MI) in patients with chronic coronary artery disease is usually associated with a rupture of atherosclerotic plaque with subsequent thrombus formation and reduction or block of blood flow what leads to necrosis of myocardium supplied by occluded artery. In some patients with MI, there are no significant lesions in coronary arteries. AIM: The comparative analysis of ST-segment elevation MI (STEMI) vs non-ST-segment elevation MI (NSTEMI) patients without significant angiographic lesions in short and long-term observation as well as identification of predictors of adverse long-term prognosis. METHODS: We analysed all subsequent patients hospitalised due to STEMI and NSTEMI, included in the Polish Registry of Acute Coronary Syndromes in years 2003-2006. Only patients without significant lesions in coronary arteries (stenosis ≤ 50%) were included. Patients were divided into two groups: STEMI and NSTEMI. In these groups we analysed in-hospital parameters, the frequency of cardiac adverse events during hospitalisation and mortality at 30 days, 6 months and 1 year. RESULTS: Patients with MI and no angiographically significant lesions in coronary arteries comprised 2.9% (n = 972) of all patients hospitalised due to MI (n = 32,959). Risk factors of coronary disease were observed more often in patients with NSTEMI. Mortality during hospitalisation, as well as after 30 days, 6 months, and 1 year was significantly higher in STEMI vs NSTEMI patients (3.5% vs 0.8%, 5.4% vs 0.8%, 8.15% vs 3.3%, 9.2% vs 4.6%). CONCLUSIONS: 1. In-hospital and long-term prognosis was worse in STEMI vs NSTEMI patients. 2. The independent predictors of adverse long-term prognosis during 1 year observation are: older age, risk factors of coronary disease like diabetes mellitus and obesity, depressed left ventricular systolic function, cardiogenic shock and STEMI.