Association of Isoprostanes-Related Oxidative Stress with Vulnerability of Culprit Lesions in Diabetic Patients with Acute Coronary Syndrome

Abstract

Urinary excretion of 8-iso-prostaglandin F2α (8-iso-PGF2α), a reliable biomarker for enhanced oxidant stress in vivo, has been described in association with diabetes and coronary heart disease. The aim of this study was to evaluate the relationship between urinary 8-iso-PGF2α levels and the characteristics of coronary culprit lesion in diabetic patients with acute coronary syndrome (ACS). A total of 79 diabetic patients with ACS were included. iMAP intravascular ultrasound (iMAP-IVUS) was performed to evaluate the characteristics of culprit plaques. Fasting urinary 8-iso-PGF2α level was measured and corrected by creatinine clearance. iMAP-IVUS data showed culprit plaques in high urinary 8-iso-PGF2α level patients had a greater percentage of necrotic core and less fibrous components. High urinary 8-iso-PGF2α levels were correlated with increased necrotic plaque components (r = 0.325, P = 0.003). Meanwhile, the presence of thin-capped fibroatheroma (50.0% versus 11.5%, P = 0.003), ruptured plaques (30.8% versus 7.7%, P = 0.035), and thrombus (38.5% versus 7.7%, P = 0.008) were significantly more frequent in the upper tertile of urinary 8-iso-PGF2α levels than in the low tertile. Multivariate analysis showed high levels of urinary 8-iso-PGF2α (OR 4.240, P = 0.007) was independently associated with the presence of vulnerable culprit plaque in diabetic ACS patients. Urinary 8-iso-PGF2α also displayed a significant value in predicting vulnerable plaques in diabetic patients with ACS by constructing the receiver-operating characteristic (ROC) curve (Area under the ROC curve: 0.713, P = 0.001). Urinary 8-iso-PGF2α levels are associated with the vulnerability of the coronary culprit lesion in diabetic patients with ACS and may provide additional information for risk assessment in suspected vulnerable patients.

Biomarkers in Stress Related Diseases/Disorders: Diagnostic, Prognostic, and Therapeutic Values

“…Besides these conditions, urinary excretion levels of 8-iso-prostaglandin (PG) F 2α has also been described for a strong association with coronary problems and diabetes. Higher urinary 8-iso-PGF 2α levels are being correlated to an increase in necrotic plaque formation and coronary culprit lesions in diabetes patients, especially with acute coronary problems (Su et al, 2019). Also, renal oxidative stress can be measured using markers, such as 3-nitrotyrosine peptides, which are stable nitrated peptides produced through the action of peroxynitrites upon protein tyrosine residues (Radi, 2013).…”

The Role of Antioxidants Supplementation in Clinical Practice: Focus on Cardiovascular Risk Factors

“…Case-control studies suggest that, in patients with T2MD, serum concentrations of oxidative stress biomarkers, such as MDA, GSSG were increased in T2MD patients, conversely, GSH levels were lower compared to controls [124]. Moreover, in urine samples of diabetic patients with the acute coronary syndrome (ACS), higher 8-iso-prostaglandin F2α (8-iso-PGF2α) levels were correlated with increased necrotic plaque components [126]. Moreover, Anderson et al measured MDA concentration and TAC levels in plasma samples of women with gestational diabetes (GDM), and both parameters resulted higher and lower, respectively [121].…”