Relationship between Prooxidant-Antioxidant Balance and Severity of Coronary Artery Disease in Patients of Imam Khomeini Hospital of Tehran, Iran

  • Fariba Nabatchican Department of Clinical Laboratory Sciences, Faculty of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
  • Nahid Einollahi Mail Department of Clinical Laboratory Sciences, Faculty of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
  • Ali Kazemi Khaledi Department of Cardiology, Faculty of Medicine, Tehran University of Medical Sciences. Tehran, Iran.
Coronary artery disease, Lipid prooxidation, Antioxidant, Oxidative stress


The balance between reactive oxygen species production and antioxidant activity has an important role in oxidative stress associated diseases including coronary artery disease. In this study, the prooxidant-antioxidant balance (PAB) and its correlations with serum lipid levels, uric acid levels, and severity of coronary artery involvement were examined. The aim of this study was to determine the diagnostic value of PAB as a predictor in coronary artery disease (CAD). Seventy two patients and 68 healthy subjects were selected. PAB was determined using standard solutions and ELISA. Triglyceride, total cholesterol, LDL-cholesterol, HDL-cholesterol and uric acid levels were measured by enzymatic method. Mean PAB was 66.4 ± 2.84 (HK units) in healthy people, 77.37 ± 33.51 (HK units) in patients with one vessel CAD, 63.76 ± 29.47 (HK units) in patients with two vessel CAD and 68.59 ± 24.51 (HK units) in patients with three or more vessel CAD. There was no significant difference between PAB values in different severity groups (P=0.41). PAB significantly and indirectly correlated with uric acid level in two vessels CAD. The study shows that PAB can be a predictor of CAD associated with other risk factors, but not alone.


Dean RT, Fu S, Stoker R, et al. Biochemistry and Pathology of radical-mediated protein oxidation. Biochem J 1997;324(Pt 1):1-18.

Stadtman ER. Oxidatio of free amino acids and amino acid residues in proteins by radiolysis and by metal-catalyzed reactions. Annu Rev Biochem 1993;62(1):797-821.

Morrissey PM, O’Brein NM. Dietary antioxidants in health and disease. Int Dairy J 1998;8:463-72.

Berger MM. Can oxidative damage be treated nutritionally? Clin Nutr 2005;24(2):172-83.

Halliwell B., Gutteridge J, editors. Free radicals in biology and medicine. 4th ed. NY:Clarendon Press, Oxford;2007.

Habdous M, Herbeth B, Vinent-Viry M, et al. Serum total antioxidant status, erythocyte superoxide dismutase and whole-blood glutathione peroxidase activities in the stanislas cohort:influencing factors and reference intervals. Clin Chem Lab Med 2003;41(2):209-15.

Alamdari DH, Paletas K, Pegiou T, et al. A novel essay for the evaluation of the prooxidant-antioxidant balance, before and after antioxidant vitamin administration in type II diabetes Patients. Clin Biochem 2007;40(3-4):248-54.

Thom TJ. International mortality from heart disease:rates and trends. Int J Epidemiol 1989:18(3 Suppl 1):S20-8.

Wilson PW, D'Agostino RB, Levy D, et al. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97(18):1837-47.

Bierman EL. George Lyman Duff Memorial Lecture. Atherogenesis in diabetes. Arterioscler Thromb 1992;12(6):647-56.

Cai H, Harrison DG. Enothelial dysfunction in cardiovascular disease: The role of oxidant stress. Circ Res 2000;87(10):840-4.

Landmesser U, Spiekermann S, Dikalov S, et al. Vascular oxidative stress and endothelial dysfunction in patients with chronic heart failure. Circulation 2002;106(24):3073-8.

Osterud B, Bjorklid E. Role of monocytes in atherogenesis. Physiol Rev 2003;83(4):1069-112.

Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardio vascular disease:application to clinical and public health practice:a statement for healthcare professionals from the centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107(3):499-511.

Kotur-Stevuljevic J, Memon L, Stefanovic A, et al. Correlation of oxidative stress parameters and inflammatory markers in coronary artery disease patients. Clin Biochem 2007;40(3-4):181-7.

Gate L, Paul J, Ba GN, et al. Oxidative stress induced in Pathologies;the role of antioxidants. Biomed pharmacother 1999;53(4):169-80.

Washio M, Sasazuki S, Kodama H, et al. Role of hypertension, dyslipidemia and diabetes mellitus in the development of coronary atherosclerosis in Japan. Jpn Circ J 2001;65(8):731-7.

Walter MF, Jacob RF, Jeffers B, et al. Serum levels of thiobarbituric acid reactive substances predict cardiovascular events in patients with stable coronary artery disease:a longitudinal analysis of the PREVENT study. J Am Coll Cardiol 2004;44(10):1996-2002.

Betteridge DJ. What is oxidative stress? Metabolism 2000;49(2 Suppl):3-8.

Dipak P, Pandya MD. Oxidant injury in coronary heart disease [Part-1]. Compr Ther 2001;27(4):284-92.

Witztum JL. The oxidation hypothesis of atherosclerosis. Lancet 1994;344(8925):793-5.

Glass CK, Witzum JL. Atherosclerosis. The road ahead. Cell 2001;104(4):503-16.

Jay D, Hitomi H, Griendling KK. Oxidative-stress and diabetic cardiovascular complications. Free Radic Biol Med 2006;40(2):183-92.

Vassalle C, Petrozzi L, Botto N, et al. Oxidative stress and its association with coronary artery disease and different atherogenic risk factors. J Intern Med 2004;256(4):308-15.

Devasagayam TP, Tilak JC, Boloor KK, et al. Free radicals and antioxidants in human health:Current status and future prospects. J Assoc physicians India 2004;52(10):794-804.

Strocker R, Keaney JF. Role of oxidative modifications in atherosclerosis. Physiol Rev 2004;84(4):1381-478.

Tatli E, Aktoz M, Buyuklu M, et al. The relationship between coronary artery disease and uric acid levels in young patients with acute myocardial infarction. Cardiol J 2008;15(1):21-5.

Torun M, Yardim S, Simsek B, et al. Serum uric acid levels in cardio vascular diseases. J clin Pharm Ther 1998;23(1):25-9.

Khosla UM, Zharikov S, Finch JL, et al. Hyperuricemia induces endothelial dysfuntion. Kidney Int 2005;67(5):1739-42.

Skinner KA, White CR, Patel R, et al. Nitrosation of uricacid by peroxynitrite. Formation of a vasoactive nitric oxide donor. J Biol Chem 1998;273(38):24491:7.

Kanellis J, Watanabe S, Li JH, et al. Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension 2003;41(6):1287-93.

Therond P, Bonnefont- Rousselot D, Davit-Sprul A, et al.Biomarkers of Oxidative stress:an analytical approach. Curr Opin Clin Nutr Metab Care 2000;3(5):373-84.

Chiu HC, Jeng JR, Shieh SM. Increased oxidizability of plasma low dinsity lipoprotein from patients with coronary artery disease. Biochim Biophys Acta 1994;1225(2):200-8.

Croft KD, Dimmitt SB, Moulton C, et al. Low density lipoprotein composition and oxidizability in coronary disease apparent favourable effectof beta blockers. Atherosclerosis 1992;97(2-3):123-30.

van de Vijver LP, Kardinaal AF, van Duyvenvoorde W, et al. LDL oxidation and extent of coronary atherosclerosis. Arterioscler Thromb Vasc Biol 1998;18(2):193-9.

Kosaka S, Okuda F, Satoh A, et al. Effect of coronary risk factors on coronary angiographic morphology in patients with ischemic heart disease. Jpn Circ J 1997;61(5):390-5.

How to Cite
Nabatchican F, Einollahi N, Kazemi Khaledi A. Relationship between Prooxidant-Antioxidant Balance and Severity of Coronary Artery Disease in Patients of Imam Khomeini Hospital of Tehran, Iran. Acta Med Iran. 52(2):116-121.