The Importance of Thiol/Disulfide Homeostasis-and Ischemia-Modified Albumin Levels in Acute Coronary Syndrome and Their Relationship with Angiographic Scoring Systems

Emrah Ermiş; Ferhat Hanikoğlu; Hakan Uçar; Samir Allahverdiyev; Erkan Yıldırım; Salim Neşelioğlu; Özcan Erel; Mehmet Dokur; Mahir Cengiz

doi:10.5152/eurjther.2020.20021

Authors

Emrah Ermiş Department of Cardiology, Biruni University, School of Medicine, Istanbul https://orcid.org/0000-0001-7292-7516
Ferhat Hanikoğlu Department of Biochemistry, Biruni University, School of Medicine, Istanbul https://orcid.org/0000-0002-6979-9469
Hakan Uçar Department of Cardiology, Biruni University, School of Medicine, Istanbul https://orcid.org/0000-0002-6979-8941
Samir Allahverdiyev Department of Cardiology, Biruni University, School of Medicine, Istanbul https://orcid.org/0000-0003-3175-0835
Erkan Yıldırım Department of Cardiology, Biruni University, School of Medicine, Istanbul https://orcid.org/0000-0001-7969-1964
Salim Neşelioğlu Department of Biochemistry, Yıldırım Beyazıt University, School of Medicine, Ankara https://orcid.org/0000-0002-0974-5717
Özcan Erel Department of Biochemistry, Yıldırım Beyazıt University, School of Medicine, Ankara https://orcid.org/0000-0002-2996-3236
Mehmet Dokur Department of Emegency Medicine, Biruni University, School of Medicine, Istanbul https://orcid.org/0000-0003-2119-3801
Mahir Cengiz Department of Internal Medicine, Biruni University, School of Medicine, Istanbul https://orcid.org/0000-0003-3343-8650

DOI:

https://doi.org/10.5152/eurjther.2020.20021

Keywords:

Thiol/disulfide homeostasis, ischemia-modified albumin, acute coronary syndrome

Abstract

Objective: The objective of this study was to investigate the differences in thiol/disulfide homeostasis- and ischemia-modified albumin (IMA) levels that are known to be associated with oxidative damage in patients with acute coronary syndrome between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction/unstable angina pectoris (NSTEMI/USAP) groups and their relationships with angiographic scoring systems.
Methods: A total of 142 patients were included in this study, with 49 in group 1 (STEMI) and 93 in group 2 (NSTEMI/USAP). Thiol/disulfide homeostasis was determined using a recently developed novel method. We investigated whether thiol/disulfide homeostasis and parameters such as IMA, troponin I, and creatine kinase MB fraction levels were associated with Gensini, and Syntax I and II scores, which are angiographic scoring systems.
Results: The native and total thiol levels were found to be statistically significantly lower in the STEMI group than in the NSTEMI/USAP group (both, p < 0.05). The serum IMA levels were statistically significantly higher in group 1 (0.59±0.12 vs 0.46±0.23 absorbance units, p<0.05). A significant positive correlation was found between the IMA and peak troponin I levels.
Conclusion: Thiol/disulfide homeostasis was shifted in favor of disulfide in the STEMI group, indicating a significant correlation between increased myocardial damage and disulfide. Similarly, the significantly higher IMA levels and positive correlation between IMA and peak troponin I in the STEMI group indicate its vulnerability in the infarcted myocardium area in addition to its vulnerability known in ischemia.

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