Association of paraoxonase activity and coronary collateral flow.

Objectives: Paraoxonase is a high-density lipoprotein-bound antioxidant enzyme that inhibits atherosclerosis and endothelial dysfunction. Coronary collateral flow is a crucial clinical entity with significant impact on the cardiovascular morbidity and mortality. This study sought to determine the relationship between the degree of angiographically visible coronary collateral circulation and serum paraoxonase activity.

Methods: The study population included 98 patients (mean age=57.9+/-10.1 years, 65 men) with angiographically documented total occlusion in one of the major coronary arteries. Development of collaterals was classified by Rentrop's method. Patients were defined as having poorly developed collaterals for Rentrop grades 0 and 1 or well-developed collaterals for Rentrop grades 2 and 3. Serum paraoxonase and arylesterase activities were measured spectrophotometrically.

Results: Statistically significant differences between well and poorly developed collateral groups in respect to serum low-density lipoprotein cholesterol level (P=0.046), and serum paraoxonase (P=0.001), and arylesterase (P=0.014) activities were present. Serum low-density lipoprotein cholesterol level (chi=4.15, beta=-0.347, P=0.032) and serum paraoxonase activity (chi=10.43, beta=0.008, P=0.022) were independent predictors of well-developed coronary collateral flow. Serum paraoxonase activity gradually increased from collateral grade 0 to collateral grade 3 (analysis of variance P=0.003). Serum paraoxonase (r=0.362 and P<0.001) and arylesterase (r=0.245 and P=0.015) activities were both correlated with collateral flow grade.

Conclusion: Findings of this study suggest that serum paraoxonase activity is independently associated with the degree of coronary collateral flow and reduced serum paraoxonase activity might represent a biochemical marker of impaired coronary collateral flow.