Relationship between Oxidative Stress Markers and Presence of Chronic Total Occlusion in Coronary Artery Disease.

Objective: To investigate the relationship between chronic total occlusion (CTO) development and oxidative stress markers in stable coronary artery patients.

Study Design: A cohort study.

Place And Duration Of Study: Cardiology Clinic, Kahramanmaras Sutcu Imam University Medical Faculty, between January 2018 and December 2019.

Methodology: Patients, who underwent coronary angiography for stable chest pain, were consecutively included. The study group consisted of those with CTO and the control group from those without CTO. Serum total oxidant/anti-oxidant, dynamic thiol/disulfide, antioxidant (ascorbate, alfa-tocopherol, beta-carotene) vitamin levels, and routine biochemistry tests of the patients were compared.

Results: The study group (24 men, 5 women, mean age 63.79 ± 9.21 years) and control group (23 men, 6 women, mean age 61.38 ± 8.20 years) consisted of 29 patients each. The oxidative stress markers (total thiol, native thiol, disulfide, reduced thiol ratio, oxidized thiol ratio, thiol oxidation-reduction ratio, total antioxidant status, total oxidant status, and vitamin E) were found to have similar values between the groups. However, of the anti-oxidative vitamins, vitamin C, vitamin A and vitamin C/vitamin E ratio were significantly lower in the CTO group and predicted a CTO lesion (AUC: 0.084, p<0.001, 95% CI: 0.007-0.162; AUC: 0.285, p=0.005, 95% CI: 0.154-0.416 and AUC: 0.181, p <0.001, 95% CI: 0.062-0.299, respectively).

Conclusion: The lower serum vitamin C and vitamin A levels and low vitamin C/vitamin E ratio may be useful in predicting the risk of CTO in stable patients with non-critical stenosis in coronary angiography.

Key Words: Chronic total occlusion, Oxidative balance, Stable coronary artery disease, Vitamin A, Vitamin C, Vitamin C / vitamin A ratio.