Antioxidant status and risk of coronary artery disease

2019 ◽  
Vol 49 (4) ◽  
pp. 700-712 ◽  
Author(s):  
Shokoofeh Talebi ◽  
Zamzam Paknahad ◽  
Mohammad Hashemi ◽  
Akbar Hasanzadeh

Purpose Coronary artery disease (CAD) is developed by an insufficient supply of oxygen-rich blood to the myocardium. Recent studies have shown that increased oxidative stress has implicated in the pathogenesis of coronary atherosclerosis. Anxiety and CAD have a mutual relationship, as the effect of long-lasting anxiety on atherosclerosis and CAD is well known. The purpose of this study is to investigate the relationship between dietary / serum total antioxidant capacity and CAD. Design/methodology/approach A total of 160 male patients were enrolled in this cross-sectional study. Diagnosis and analysis of angiograms were performed visually by a cardiologist. The subjects were categorized into CAD− (coronary artery obstruction <75 per cent) and CAD+ (coronary artery obstruction ≥ 75 per cent) groups. Anthropometric indices, blood pressure, blood sugar and lipid profile and physical activity (PA) were assessed. Information about anxiety was obtained by Spielberger questionnaire. Dietary total antioxidant capacity (TAC) was obtained by using a semi-quantitative food frequency questionnaire and an oxygen radical absorbance capacity of selected foods. Findings Mean of dietary TAC was significantly lower in CAD+ than CAD− group (P < 0.001). However, there was not any significant differences about serum TAC (P = 0.28). The mean of body mass index (BMI) (P = 0.04) and triglyceride (TG) level (P = 0.03) and the frequency of smoking (P = 0.03) were significantly higher in the CAD+ than the CAD− group. There was no significant relationship between CAD with apparent (P = 0.33) and hidden anxiety level (P = 0.16). Confounding factors such as smoking and medications were adjusted. Research limitations/implications This study had certain limitations. Being a single center cross-sectional design does not permit analysis of causal relationships; the sample size was geographically limited. The authors could not exclude the medication of patients, which could affect the total antioxidant capacity levels. Measurement error in self-reported dietary consumption may results misclassification of exposure. Practical implications A diet high in total antioxidant capacity is inversely associated with CAD. Serum TAC does not vary between men with and without CAD when confounders including age, BMI, TG, smoking, SBP, DBP, energy intake, PA, HDL-C, LDL-C, T-C, FBS, family history of CAD, education and anxiety are taken into consideration. Social implications High consumption of vegetables and fruits may play a major role in the prevention of CAD. Originality/value The study was approved by the ethics committee of Isfahan University of Medical Sciences (No:394888).

BMJ ◽  
2021 ◽  
pp. n48
Author(s):  
Yuanxi Jia ◽  
Jiajun Wen ◽  
Riaz Qureshi ◽  
Stephan Ehrhardt ◽  
David D Celentano ◽  
...  

Abstract Objective To identify redundant clinical trials evaluating statin treatment in patients with coronary artery disease from mainland China, and to estimate the number of extra major adverse cardiac events (MACEs) experienced by participants not treated with statins in those trials. Design Cross sectional study. Setting 2577 randomized clinical trials comparing statin treatment with placebo or no treatment in patients with coronary artery disease from mainland China, searched from bibliographic databases to December 2019. Participants 250 810 patients with any type of coronary artery disease who were enrolled in the 2577 randomized clinical trials. Main outcome measures Redundant clinical trials were defined as randomized clinical trials that initiated or continued recruiting after 2008 (ie, one year after statin treatment was strongly recommended by clinical practice guidelines). The primary outcome is the number of extra MACEs that were attributable to the deprivation of statins among patients in the control groups of redundant clinical trials—that is, the number of extra MACEs that could have been prevented if patients were given statins. Cumulative meta-analyses were also conducted to establish the time points when statins were shown to have a statistically significant effect on coronary artery disease. Results 2045 redundant clinical trials were identified published between 2008 and 2019, comprising 101 486 patients in the control groups not treated with statins for 24 638 person years. 3470 (95% confidence interval 3230 to 3619) extra MACEs were reported, including 559 (95% confidence interval 506 to 612) deaths, 973 (95% confidence interval 897 to 1052) patients with new or recurrent myocardial infarction, 161 (132 to 190) patients with stroke, 83 (58 to 105) patients requiring revascularization, 398 (352 to 448) patients with heart failure, 1197 (1110 to 1282) patients with recurrent or deteriorated angina pectoris, and 99 (95% confidence interval 69 to 129) unspecified MACEs. Conclusions Of more than 2000 redundant clinical trials on statins in patients with coronary artery disease identified from mainland China, an extra 3000 MACEs, including nearly 600 deaths, were experienced by participants not treated with statins in these trials. The scale of redundancy necessitates urgent reform to protect patients.


2021 ◽  
Vol 129 (Suppl_1) ◽  
Author(s):  
Dinaldo C Oliveira ◽  
Edivaldo Mendes Filho ◽  
Mariana Barros ◽  
Carolina Oliveira ◽  
Joao Vitor Cabral ◽  
...  

Introduction: Interleukin L-17 is produced by Th 17 cells and other cells. There is a debate if IL 17 is atherogenic or atheroprotective. The true role of this interleukin during the development and progression of the coronary artery disease is not known. Objective: To evaluate if there are differences between the IL17 A serum levels according to clinical presentation of the coronary artery disease. Methods: This is a cross sectional study which enrolled 101 patients with acute coronary syndrome (ACS), 100 patients with chronic coronary syndrome (CCS) and 100 healthy volunteers. Blood samples were taken from patients ( at admission) and controls to analysis the level of IL17A. Clinical characteristics were collected through questionnaires. This research was approved by ethical committee. Results: Comparisons of the clinical characteristics between patients with ACS and CCS revealed: mean age ( 62 ± 12.4 vs 63.3 ± 9.8, p = 0.4 ), male (63.4% vs 58%, p = 0.4) hypertension (85.1% vs 79%, p = 0.1) , disyipidemia (48% vs 31%, p =0.01), Diabetes Mellitus (47.5% vs 41%, p = 0.3), previous myocardial infarction (57.4% vs 40%, p = 0,01), smoking (29.7% vs 38%, p = 1). The peripheral concentrations of IL17A according to ACS, CCS and controls were: 5.36 ± 8.83 vs 6.69 ± 17.92 vs 6.26 ± 11.13, p = 0.6. Besides, the comparison between ACS and CCS showed: 5.36 ± 8.83 vs 6.69 ± 17.92, p = 0.3. Conclusion: The main finding os this study was that the circulating IL 17 concentrations were similar in patients with ACS, CCS and healthy volunteers). Besides, there was no difference between patients with ACS and CCS. Therefore, our hypothesis is that in patients with ACS and CCS the circulating IL 17 A concentrations are low or undetectable.


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