Skip to main content

Advertisement

Log in

Serum Zinc Measurement, Total Antioxidant Capacity, and Lipid Peroxide Among Acute Coronary Syndrome Patients With and Without ST Elevation

  • Published:
Applied Biochemistry and Biotechnology Aims and scope Submit manuscript

Abstract

Despite advances in the management of cardiovascular diseases, acute coronary syndrome (ACS) remains the leading cause of death worldwide. ACS is associated with an imbalance between coronary blood supply and metabolic requirements. Lipid peroxidation and production of reactive oxygen species (ROS) damage the cardiac cell membrane. A total of 130 subjects, 65 ACS patients (45 with ST segment elevation (STE-ACS), 20 non-STE-ACS), and 65 healthy controls were recruited. Measurement of serum zinc, total antioxidant capacity (TAC) and malondialdehyde (MDA) by spectrophotometric methods 24 h after onset of ACS, and relations between the studied biochemical parameters and risk factors were performed. MDA levels were significantly increased; TAC and zinc levels were significantly decreased in ACS patients compared to the controls (P < 0.001 for each). No significant difference was detected between the different types of ACS and each of the oxidative stress parameters, cardiac biomarkers, lipogram, and risk factors. Only serum zinc in STE-ACS patients was significantly lower compared with NSTE-ACS patients (P < 0.001). Serum zinc showed the greatest AUC (area under the ROC curve) of 0.926 with 76.92% sensitivity and 95.38% specificity. Negative and positive correlations between MDA and zinc and between TAC and zinc levels respectively (P < 0.01) were found in ACS. Week negative correlation was observed between serum zinc and SYNTAX score (r = − 0.434, P = 0.049). Our results indicate that deficient serum zinc concentration strongly associated with the etiopathogenesis of ACS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Afridi, H. I., Kazi, T. G., Kazi, N., Kandhro, G. A., Baig, J. A., Shah, A. Q., Jamali, M. K., Arain, M. B., Wadhwa, S. K., & Khan, S. (2011). Chromium and manganese levels in biological samples of Pakistani myocardial infarction patients at different stages as related to controls. Biological Trace Element Research, 142(3), 259–273.

    Article  CAS  Google Scholar 

  2. Afridi, H. I., Kazi, T. G., Kazi, N., Talpur, F. N., Arain, S., Brahman, K., Wadhwa, S., & Shah, F. (2013). Distribution of copper, iron, and zinc in biological samples of Pakistani hypertensive patients and referent subjects of different age groups. Clinical Laboratory, 59(9-10), 959–967.

    CAS  PubMed  Google Scholar 

  3. Akın, F., Köse, N., Ayça, B., Katkat, F., & Arınç, H. (2013). Relation between red cell distribution width and severity of coronary artery disease in patients with acute myocardial infarction. Journal of the American College of Cardiology, 62(18), C203.

    Article  Google Scholar 

  4. AL-Rasheed, N. M., Attia, H. A., Mohamed, R. A., Al-Rasheed, N. M., & Al-Amin, M. A. (2014). Preventive effects of selenium yeast, chromium picolinate, zinc sulfate and their combination on oxidative stress, inflammation, impaired angiogenesis and atherogenesis in myocardial infarction in rats. Journal of Pharmacy & Pharmaceutical Sciences, 16(5), 848–867.

    Article  Google Scholar 

  5. Aydın, M., Selcoki, Y., Nazlı, Y., Çolak, N., Yalçın, K. S., Canbal, M., Demirçelik, B., Yiğitoğlu, R., & Eryonucu, B. (2012). Relationship between total antioxidant capacity and the severity of coronary artery. Journal of Clinical and Experimental Investigations, 3. www.jceionline.org.

  6. Azab, B., Torbey, E., Hatoum, H., Singh, J., Khoueiry, G., Bachir, R., McGinn Jr., J. T., McCord, D., & Lafferty, J. (2011). Usefulness of red cell distribution width in predicting all-cause long-term mortality after non-ST-elevation myocardial infarction. Cardiology, 119(2), 72–80.

    Article  Google Scholar 

  7. Bagatini, M. D., Martins, C. C., Battisti, V., Gasparetto, D., Da Rosa, C. S., Spanevello, R. M., Ahmed, M., Schmatz, R., Schetinger, M. R. C., & Morsch, V. M. (2011). Oxidative stress versus antioxidant defenses in patients with acute myocardial infarction. Heart and Vessels, 26(1), 55–63.

    Article  Google Scholar 

  8. Bax, J. J., Baumgartner, H., Ceconi, C., Dean, V., Fagard, R., Funck-Brentano, C., Hasdai, D., Hoes, A., Kirchhof, P., & Knuuti, J. (2012). Third universal definition of myocardial infarction. Journal of the American College of Cardiology, 60, 1581–1598.

    Article  Google Scholar 

  9. Börekçi, A., Gür, M., Türkoğlu, C., Çaylı, M., Selek, Ş., Kaypaklı, O., Uçar, H., Coşkun, M., Şeker, T., & Koç, M. (2015). Oxidative stress and paraoxonase 1 activity predict contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology, 66(4), 339–345.

    Article  Google Scholar 

  10. Brunori, E. H. F. R., Lopes, C. T., Cavalcante, A. M. R. Z., Santos, V. B., Lopes, J. d. L., & Barros, A. L. B. L. d. (2014). Association of cardiovascular risk factors with the different presentations of acute coronary syndrome. Revista Latino-Americana de Enfermagem, 22(4), 538–546.

    Article  Google Scholar 

  11. Chacko, S., Haseeb, S., Glover, B. M., Wallbridge, D., & Harper, A. (2017). The role of biomarkers in the diagnosis and risk stratification of acute coronary syndrome. Future Science OA, 4, FSO251.

    Article  Google Scholar 

  12. Chapman, A. R., Adamson, P. D., & Mills, N. L. (2016). Assessment and classification of patients with myocardial injury and infarction in clinical practice. Heart, heartjnl-2016-309530.

  13. Chasapis, C. T., Loutsidou, A. C., Spiliopoulou, C. A., & Stefanidou, M. E. (2012). Zinc and human health: an update. Archives of Toxicology, 86(4), 521–534.

    Article  CAS  Google Scholar 

  14. Foster, M., & Samman, S. (2011). 17. Zinc and atherosclerosis: clinical observations and potential mechanisms. Zinc in Human Health, 76, 347.

    CAS  Google Scholar 

  15. Gil, G. P., Dessotte, C. A. M., Schmidt, A., Rossi, L. A., & Dantas, R. A. S. (2012). Clinical evolution of patients hospitalized due to the first episode of acute coronary syndrome. Revista Latino-Americana de Enfermagem, 20(5), 830–837.

    Article  Google Scholar 

  16. González-Pacheco, H., Amezcua-Guerra, L. M., Vazquez-Rangel, A., Martínez-Sánchez, C., Pérez-Méndez, O., Verdejo, J., & Bojalil, R. (2015). Levels of high-density lipoprotein cholesterol are associated with biomarkers of inflammation in patients with acute coronary syndrome. American Journal of Cardiology, 116(11), 1651–1657.

    Article  Google Scholar 

  17. Gupta, M., & Chari, S. (2006). Proxidant and antioxidant status in patients of type II diabetes mellitus with IHD. Indian Journal of Clinical Biochemistry, 21(2), 118–122.

    Article  CAS  Google Scholar 

  18. Gür, M., Türkoğlu, C., Taşkın, A., Uçar, H., Börekçi, A., Şeker, T., Gözükara, M. Y., Kaypaklı, O., Akyol, S., & Selek, Ş. (2014). Paraoxonase-1 activity and oxidative stress in patients with anterior ST elevation myocardial infarction undergoing primary percutaneous coronary intervention with and without no-reflow. Atherosclerosis, 234(2), 415–420.

    Article  Google Scholar 

  19. Hochman, J. S., Buller, C. E., Sleeper, L. A., Boland, J., Dzavik, V., Sanborn, T. A., Godfrey, E., White, H. D., Lim, J., & LeJemtel, T. (2000). Cardiogenic shock complicating acute myocardial infarction—etiologies, management and outcome: a report from the SHOCK Trial Registry. Journal of the American College of Cardiology, 36(3), 1063–1070.

    Article  CAS  Google Scholar 

  20. Huang, L., Teng, T., Bian, B., Yao, W., Yu, X., Wang, Z., Xu, Z., & Sun, Y. (2017). Zinc levels in left ventricular hypertrophy. Biological Trace Element Research, 176(1), 48–55.

    Article  CAS  Google Scholar 

  21. Huang, L., Teng, T., Zhao, J., Bian, B., Yao, W., Yu, X., Wang, Z., Xu, Z., & Sun, Y. (2018). The relationship between serum zinc levels, cardiac markers and the risk of acute myocardial infarction by zinc quartiles. Heart, Lung and Circulation, 27(1), 66–72.

    Article  Google Scholar 

  22. Jain, V., & Mohan, G. (1991). Serum zinc and copper in myocardial infarction with particular reference to prognosis. Biological Trace Element Research, 31(3), 317–322.

    Article  CAS  Google Scholar 

  23. Kilic, A., Yarlioglues, M., Ercan, E. A., Duran, M., Ugurlu, M., Oksuz, F., Ozdemir, S., Kurtul, A., Karadeniz, M., & Murat, S. N. (2015). Association of total serum antioxidant capacity with the Tei index in echocardiography in patients with microvascular angina. Coronary Artery Disease, 26(7), 620–625.

    Article  Google Scholar 

  24. Koracevic, D., Koracevic, G., Djordjevic, V., Andrejevic, S., & Cosic, V. (2001). Method for the measurement of antioxidant activity in human fluids. Journal of Clinical Pathology, 54(5), 356–361.

    Article  CAS  Google Scholar 

  25. Krachler, M., & Irgolic, K. (1999). The potential of inductively coupled plasma mass spectrometry (ICP-MS) for the simultaneous determination of trace elements in whole blood, plasma and serum. Journal of Trace Elements in Medicine and Biology, 13(3), 157–169.

    Article  CAS  Google Scholar 

  26. Lavall, M. C., Bonfanti, G., Ceolin, R. B., Schott, K. L., Gonçalves, L. T., Moresco, R. N., Brucker, N., Morsch, V. M., Bagatini, M. D., & Schetinger, M. (2016). Oxidative profile of patients with ST segment elevation myocardial infarction. Clinical Laboratory, 62(5), 971–973.

    CAS  PubMed  Google Scholar 

  27. Lee, S. R., Noh, S. J., Pronto, J. R., Jeong, Y. J., Kim, H. K., Song, I. S., Xu, Z., Kwon, H. Y., Kang, S. C., & Sohn, E.-H. (2015). The critical roles of zinc: beyond impact on myocardial signaling. The Korean Journal of Physiology & Pharmacology, 19(5), 389–399.

    Article  CAS  Google Scholar 

  28. Li, F., Gao, J., & Zhang, B. (2016). Association between deficient selenium levels and myocardial infarction: a meta-analysis. International Journal of Clinical and Experimental Medicine, 9, 6086–6092.

    CAS  Google Scholar 

  29. Madole, M. B., Bachewar, N. P., & Aiyar, C. M. (2015). Study of oxidants and antioxidants in patients of acute myocardial infarction. Advanced Biomedical Research, 4, 241.

    PubMed  PubMed Central  Google Scholar 

  30. Malavolta, M., Costarelli, L., Giacconi, R., Basso, A., Piacenza, F., Pierpaoli, E., Provinciali, M., Ogo, O. A., & Ford, D. (2017). Changes in Zn homeostasis during long term culture of primary endothelial cells and effects of Zn on endothelial cell senescence. Experimental Gerontology, 99, 35–45.

    Article  CAS  Google Scholar 

  31. Martin-Moreno, J., Gorgojo, L., Riemersma, R., Gomez-Aracen, J., Kark, J., Guillen, J., Jimenez, J., Ringstad, J., Fernandez-Crehuet, J., & Bode, P. (2003). Myocardial infarction risk in relation to zinc concentration in toenails. British Journal of Nutrition, 89(05), 673–678.

    Article  CAS  Google Scholar 

  32. Members, A. T. F., Steg, P. G., James, S. K., Atar, D., Badano, L. P., Lundqvist, C. B., Borger, M. A., Di Mario, C., Dickstein, K., & Ducrocq, G. (2012). ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). European Heart Journal, 33(20), 2569–2619.

    Article  Google Scholar 

  33. More, H., Pujari, K., Jadkar, S., & Patil, C. (2017). Biochemical parameters in acute myocardial infarction with or without co-morbidities. Journal of Medical Science and Clinical Research, 5(02), 17299–17304.

    Article  Google Scholar 

  34. Movahed, A., Iranpour, D., Nabipour, I., Jafari, M., Akbarzadeh, S., Assadi, M., Mirzaei, K., & Hagian, N. (2012). Plasma malondialdehyde, bilirubin, homocysteine and total antioxidant capacity in patients with angiographically defined coronary artery disease. African Journal of Biotechnology, 11, 3187–3191.

    CAS  Google Scholar 

  35. Panicker, S., Swathy, S., John, F., & Madambath, I. (2010). Impact of selenium on NFκB translocation in isoproterenol-induced myocardial infarction in rats. Biological Trace Element Research, 138(1-3), 202–211.

    Article  CAS  Google Scholar 

  36. Patil, N., Chavan, V., & Karnik, N. (2007). Antioxidant status in patients with acute myocardial infarction. Indian Journal of Clinical Biochemistry, 22(1), 45–51.

    Article  CAS  Google Scholar 

  37. Piegas, L. S., Avezum, Á., Pereira, J. C. R., Neto, J. M. R., Hoepfner, C., Farran, J. A., Ramos, R. F., Timerman, A., & Esteves, J. P. (2003). Risk factors for myocardial infarction in Brazil. American Heart Journal, 146(2), 331–338.

    Article  Google Scholar 

  38. Powell, S. R. (2000). The antioxidant properties of zinc. The Journal of Nutrition, 130(5), 1447S–1454S.

    Article  CAS  Google Scholar 

  39. Reihani, H., Shamloo, A. S., & Keshmiri, A. (2018). Diagnostic value of D-dimer in acute myocardial infarction among patients with suspected acute coronary syndrome. Cardiology Research, 9(1), 17–21.

    Article  Google Scholar 

  40. Roffi, M., Patrono, C., Collet, J.-P., Mueller, C., Valgimigli, M., Andreotti, F., Bax, J. J., Borger, M. A., Brotons, C., & Chew, D. P. (2016). 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). European Heart Journal, 37(3), 267–315.

    Article  CAS  Google Scholar 

  41. Srilakshmi, P., Swetha, D., & Rambabu, K. (2015). Oxidative stress in acute coronary syndrome. Journal of Evolution of Medical and Dental Sciences, 4, 15201–15208.

    Article  CAS  Google Scholar 

  42. Steg, G. (2012). Third universal definition of myocardial infarction. European Heart Journal, 33, 2551.

    Article  Google Scholar 

  43. Tardif, J.-C. (2003). Oxidative stress and coronary heart disease. Cardiology Rounds, 7.

  44. Terént, A., & Andersson, B. (1981). The prognosis for patients with cerebrovascular stroke and transient ischemic attacks. Upsala Journal of Medical Sciences, 86(1), 63–74.

    Article  Google Scholar 

  45. Thayer, W. S. (1984). Serum lipid peroxides in rats treated chronically with adriamycin. Biochemical Pharmacology, 33(14), 2259–2263.

    Article  CAS  Google Scholar 

  46. Xu, Z., & Zhou, J. (2013). Zinc and myocardial ischemia/reperfusion injury. Biometals, 26(6), 863–878.

    Article  CAS  Google Scholar 

  47. Yarlioglues, M., & Kurtul, A. (2017). Association of red cell distribution width with noninfarct-related artery-chronic total occlusion in acute myocardial infarction patients. Biomarkers in Medicine, 11(3), 255–263.

    Article  CAS  Google Scholar 

  48. Yu, X., Huang, L., Zhao, J., Wang, Z., Yao, W., Wu, X., Huang, J., & Bian, B. (2018). The relationship between serum zinc level and heart failure: a meta-analysis. BioMed Research International, 2018, 1–9.

    Google Scholar 

  49. Zampaglione, B., Pascale, C., Marchisio, M., & Cavallo-Perin, P. (1996). Hypertensive urgencies and emergencies: prevalence and clinical presentation. Hypertension, 27(1), 144–147.

    Article  CAS  Google Scholar 

  50. Zhao, Z., Liu, T., Li, J., Yang, W., Liu, E., & Li, G. (2014). Elevated red cell distribution width level is associated with oxidative stress and inflammation in a canine model of rapid atrial pacing. International Journal of Cardiology, 174(1), 174–176.

    Article  Google Scholar 

Download references

Funding

This research was funded by the authors themselves.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Reham I. El-Mahdy.

Ethics declarations

The study was approved by the Faculty of Medicine, Assiut University ethical committee in accordance with Helsinki declaration (1975).

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

El-Mahdy, R.I., Mostafa, M.M. & EL-Deen, H.S. Serum Zinc Measurement, Total Antioxidant Capacity, and Lipid Peroxide Among Acute Coronary Syndrome Patients With and Without ST Elevation. Appl Biochem Biotechnol 188, 208–224 (2019). https://doi.org/10.1007/s12010-018-2917-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12010-018-2917-x

Keywords

Navigation