Comparison of Inflammatory and Oxidative Stress Markers Among Patients with Non-Obstructive vs. Obstructive Coronary Artery Disease

Abstract

BACKGROUND. Myocardial infarction with non-obstructive coronary artery disease (MINOCA) accounts for 5-20% of all cases of myocardial infarction. The growing evidence indicates the importance of oxidative stress and chronic inflammation in the heterogenous pathophysiology of MINOCA. OBJECTIVES In the present study, we aimed to evaluate oxidative and inflammatory statuses in patients with MINOCA and compare them with the same indices of patients with obstructive coronary disease non-ST-elevation acute coronary syndrome (NSTE-ACS). METHODS Overall, 165 of 1018 patients admitted to the Coronary Care Unit of Tsinamdzgvrishvili Center of Cardiology LTD (Tbilisi, Georgia) because of the first episode of acute coronary syndrome (ACS) was divided into two groups: 115 patients with MINOCA were distributed into the group 1, and 50 patients with obstructive coronary disease NSTE-ACS into the group 2. Oxidative stress and inflammatory markers were evaluated in study patients. RESULTS We found an increase in free radical concentrations in both groups of study patients, but there was no difference in the mean amount of overall organic radicals (FORT)(p=0.412). We also found a significantly lower mean concentration of plasmatic antioxidant compounds (FORD) in patients with MINOCA (p=0.036) compared with NSTE-ACS patients, indicating a more pronounced depletion of antioxidant potential in MINOCA patients. The results of admission inflammatory markers, such as hs-CRP and hemogram-derived NLR, suggest significantly higher inflammatory status in MINOCA patients than in those with NSTE-ACS. CONCLUSIONS The results of the present study emphasize the significance of oxidative stress and inflammation in the pathogenesis of MINOCA.