Plasma concentrations of thioredoxin, thioredoxin reductase and peroxiredoxin-4 can identify high risk patients and predict outcome in patients with acute coronary syndrome: A clinical observation

• Published in: International journal of cardiology Vol. 403; p. 131888
• Main Authors: Doughty, Angela, Keane, Gary, Wadley, Alex J., Mahoney, Berenice, Bueno, Allain A., Coles, Steven J.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.05.2024
• Subjects: ACS; LAD; NSTEMI; PRDX4; TRX; TRXR; NSTEMI; ACS; PRDX4; TRX; LAD; TRXR
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2024.131888

Oxidative stress is a pathological feature of acute coronary syndrome (ACS), a complex disease with varying clinical outcomes. Surrogate biomarkers of oxidative stress including, peroxiredoxin-2 (PRDX2), PRDX4, thioredoxin (TRX) and thioredoxin reductase (TRXR) were measured in ACS patients at presentation and follow-up, to assess their clinical utility in diagnosis and risk stratification. Plasma from 145 participants (80 ACS and 65 healthy) at diagnosis, 1–3 month (first) and 6-month follow-up (second) was analysed by ELISA. ACS patients were monitored for 12-months. ACS patients at diagnosis had significantly higher concentrations of TRX (p < 0.05), TRXR (p < 0.01) and PRDX4 (p < 0.01), compared to healthy donors. This was increase was driven by non-ST elevated myocardial infarction for TRX (p < 0.01) and PRDX4 (p < 0.05). For TRXR, ACS females were significantly higher than males (p < 0.05). TRX was also higher in older females (>55 years) at diagnosis (p < 0.05). At first follow-up, TRX had lowered, whereas PRDX4 remained significantly high (p < 0.05). Stratification of ACS patients according to percutaneous coronary intervention (PCI) revealed that TRXR was significantly higher in patients receiving PCI to the right coronary artery (p < 0.05). Whereas both TRXR (p < 0.01) and PRDX4 (p < 0.01) were significantly higher in patients receiving PCI to the left anterior descending (LAD) artery. ACS patients who had plasma TRX >13.40 ng/ml at second follow-up were at high risk of readmission (p < 0.05), as were patients with TRXR of <1000 pg/ml at diagnosis having PCI to the LAD (p < 0.05). This study indicates that TRX, TRXR and PRDX4 may have clinical utility for ACS stratification. •Plasma TRX and PRDX4 concentrations are raised in NSTEMI ACS patients at diagnosis.•Plasma TRXR is higher in younger ACS females compared with younger ACS males.•At admission, plasma TRXR and PRDX4 concentrations are raised in PCI to LAD ACS patients.•ACS patients with plasma TRX >13.40 ng/ml at 6-months have an increased risk of readmission.•LAD ACS patients with plasma TRXR <1000 pg/ml on admission have an increased risk of readmission.