Apoptosis kinetics at reperfusion period in patients with acute ST-Segment Elevation Myocardial Infarction undergoing primary percutaneous coronary intervention and treated with thrombolytic therapy

• Published in: Journal of the Pakistan Medical Association Vol. 66; no. 7; pp. 808 - 814
• Main Authors: Gultekin, Nazmi, Bulut, Gulsum, Kucukates, Emine, Yildiz, Ahmet, Kocas, Cuneyt, Bulut, Leyla
• Format: Journal Article
• Language: English
• Published: Pakistan Knowledge Bylanes 01.07.2016
• Subjects: Aged; Apoptosis; Balloon angioplasty; Cardiac patients; Cardiology; Care and treatment; Creatine Kinase, MB Form - blood; Electrocardiography - methods; Female; Heart attack; Humans; Male; Middle Aged; Myocardial Reperfusion Injury - etiology; Myocardial Reperfusion Injury - metabolism; Myocardial Reperfusion Injury - physiopathology; Myocytes, Cardiac - metabolism; Myocytes, Cardiac - pathology; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - methods; Prospective Studies; ST Elevation Myocardial Infarction - diagnosis; ST Elevation Myocardial Infarction - metabolism; ST Elevation Myocardial Infarction - physiopathology; ST Elevation Myocardial Infarction - therapy; Statistics as Topic; Thrombolytic Therapy - adverse effects; Troponin - blood; Turkey; Apoptosis kinetics, ST-segment elevation, Acute coronary syndrome, Primary percutaneous coronary intervention, Thrombolytic therapy
• ISSN: 0030-9982

To evaluate the kinetics of cardiomyocyte apoptosis in patients undergoing primary percutaneous coronary intervention and thrombolytic therapy in order to elucidate the dark side of reperfusion injury. The prospective descriptive study was conducted at Istanbul University Cardiology Institute, Istanbul, Turkey, between June 2010 and December 2012. It comprised patients with persistent ST-segment elevation myocardial infarction who were divided into two groups. Patients in group 1 were treated with percutaneous coronary intervention, while those in group 2 received thrombolytic therapy. Cell death detection enzyme-linked immunosorbent assay kit was used for the analysis of cardiomyocyte apoptosis. Venous blood samples were collected to determine the apoptotic activity from the patients at the beginning of thrombolysis in myocardial infarction grade 3 of reperfusion in infarct-related artery according to thrombolysis in myocardial infarction classification, and after reperfusion provided at 6, 12, 24 and 72 hours. Creatine kinase, peak creatine kinase myocardial band and troponin levels were determined on admission and during 24hours of ST-segment elevation myocardial infarction . SPSS 15 was used for statistical analysis. There were 92 patients in the study; 48(51.6%) in group 1 and 44(48.4%) in group 2.There was no significant correlation between peak apoptotic activity levels at 72 hours of reperfusion and peak creatine kinase myocardial band (r=0.05;p=0.66) or the troponin (r=0.10;p=0.38) levels at 24 hours of ST-segment elevation myocardial infarction. Apoptotic activity levels increased at 72 hours compared to the baseline both for group 1 (p<0.001) and group 2(p<0.001). Reperfusion injury was not primarily related to apoptosis and it was a slowly progressive benign event in patients with ST-segment elevation myocardial infarction-acute coronary syndrome. Also, the negative impact of percutaneous coronary intervention was not available on reperfusion injury.