Oxidative Stress and Paraoxonase 1 Activity Predict Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract

Reactive oxygen species have been implicated in the pathogenesis of contrast-induced nephropathy (CIN). We investigated the relationship between CIN with paraoxonase 1 (PON-1) activity and oxidative stress markers (total antioxidant status [TAS], total oxidant status [TOS], and oxidative stress index [OSI]) in patients with anterior ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention; 289 consecutive patients with STEMI were prospectively included. The patients were divided into 2 groups: CIN (n = 69) and non-CIN (n = 220). Activity of PON-1 and TAS levels were significantly lower and OSI and TOS levels were significantly higher in patients with CIN compared to the non-CIN group (P < .05, for all). On multivariate logistic regression analysis, PON-1 activity and OSI as well as the amount of contrast medium and diabetes were independent predictors for CIN in patients with anterior STEMI. Activity of PON-1 and oxidative stress may play a role in the pathogenesis of CIN.

Serum albumin and the risk of contrast-induced acute kidney injury after percutaneous coronary intervention

“…Common risk factors of CIAKI development include advanced age, chronic renal dysfunction, heart failure, concomitant administration of nephrotoxic drugs, decreased blood volume, LVEF and type and dose of contrast media (Barrett and Parfrey, 2006;Börekci et al, 2015;Heyman et al, 2008;Yin et al, 2017). Development of CIAKI is one of the most important problems following PCI (Mehran et al, 2003).…”

“…Contrast-induced acute kidney injury (CIAKI) ranks 3rd among causes of hospital-acquired renal insufficiency in hospitalized patients and has been known to increase the morbidity and mortality, dialysis and transplantation, health care costs and length of hospitalization (Best et al, 2002;Mehta et al, 2015;Nash et al, 2002). Although the pathogenesis of CIAKI has not been fully described, previous studies have demonstrated that inflammation, thrombosis, renal parenchymal hypoxia and reactive oxidative stress (ROS) induced by oxygen species are all related to its occurrence (Barrett and Parfrey, 2006;Börekci et al, 2015;Heyman et al, 2008). Meanwhile, CIAKI development has been linked to increased early and late morbidity and mortality in patients who have undergone percutaneous coronary intervention (PCI) (Wi et al, 2011).…”

Association of contrast-induced nephropathy with bare metal stent restenosis in STEMI patients treated with primary PCI

“…Oxidative stress markers and paraoxonase-1 activity were found to be independent predictors of CIN in STEMI patients undergoing primary PCI. 29 In another study, CRP levels were found to be correlated with creatinine clearance in patients with acute coronary syndrome. 30 These findings indicate a common systemic pathophysiological pathway which involves inflammatory reactions that cause damage to renal cells and hyper-activation of vascular cells resulting in higher risk for CIN and SR.…”

Clinical effect of trimetazidine on prevention of contrast-induced nephropathy in patients with renal insufficiency

“…TMZ is a piperazine derivative, which is a inhibitor of mitochondrial long-chain 3-acyl coenzyme A. Basic research [29,30] confirmed that TMZ can inhibit the production of oxygen-free radical, reduce apoptosis, prevent mitochondrial swelling, enhance mitochondrial activity, and prevent cell lysis, thereby protecting the cell function. In addition, TMZ can improve the concentration of intracellular SOD, which is a part of the main substances in removing oxygen-free radicals.…”