DOI: https://doi.org/10.22141/2224-0586.1.72.2016.74473

Effects of Intravenous 5-Lipoxygenase Inhibitor Quercetin Therapy on Endothelial Function, Severity of Systemic Inflammation and Oxidative Stress in Acute ST Elevation Myocardial Infarction

Ya.M. Lutai, O.M. Parkhomeko, N.O. Ryzhkova, T.I. Havrylenko, O.I. Irkin, S.M. Kozhukhov, A.O. Stepura, D.O. Bilyi

Abstract


The objective was to evaluate the antioxidant and anti-inflammatory activity of 5-lipoxygenase inhibitor quercetin, as well as the impact of the drug on endothelial function in patients with acute coronary syndrome (ACS) with ST-segment elevation on the electrocardiogram on the background of modern treatment. The study involved 94 patients who were hospitalized within the first 12 hours of developing symptoms of the disease and received reperfusion therapy by primary angioplasty method. Patients were divided into two groups in a ratio of 2 : 1. In addition to the basic treatment for ACS, 60 patients received 5-lipoxygenase inhibitor quercetin, 34 patients were in the control group. Patients in both groups did not differ in main clinical and anamnestic parameters, characteristics of myocardial infarction and basic treatment. Results of tests with flow-dependent vasodilation (FDV) on the 1st day in both groups did not differ (p = 0.654). During hospital period, we marked a significant increase in brachial artery diameter in FDV in corvitin group (6.45 ± 1.02 % on the 1st day against 9.96 ± 0.94 % on the 7th day, respectively, p = 0.004) in the absence of changes in the control group (p = 0.324). Quercetin therapy had not a significant impact on the dynamics of von Willebrand factor, soluble E-selectin, soluble CD40 ligand and C-reactive protein levels. We have detected a significant increase in the content of vascular endothelial growth factor on the 7th day in quercetin group (149.3 ± 47.2 pcg/ml on the 1st day versus 396.0 ± 64.7 pg/ml on the 7th day, respectively, p = 0.002) as opposed to the control group (p = 0.373). The level of myeloperoxidase (MPO) in the blood plasma of patients with acute myocardial infarction (AMI) on the 1st day in two selected groups did not differ significantly (p = 0.603). We have revealed a strong inverse correlation (r = –0.46; p = 0.006) between MPO content in the blood plasma and results of FDV on the 1st day, as well as an inverse correlation between the changes in MPO level and FDV changes in the dynamics of hospital period (r = –0.40; p = 0.01). Quercetin therapy led to a significant reduction of MPO in the blood plasma of patients with AMI (611.7 ± 83.3 ng/ml on the 1st day versus 382.4 ± 65.4 ng/ml on the 7th day, p = 0.013), which was not observed in the control group (525.9 ± 122.3 ng/ml on the 1st day versus 437.6 ± 104.8 ng/ml on the 7th day, p = 0.210). According to the results of clinical observation, patients who in addition to basic therapy received quercetin were characterized by a decrease in the manifestations of acute left ventricular failure during the hospital period. Thus, the administration of 5-lipoxygenase inhibitor quercetin to AMI patients with ST-segment elevation has not additional anti-inflammatory effect, but has a positive effect on endothelial function and antioxidant properties (reduction of MPO level), which causes downward trend in hospital-acquired complications on the background of quercetin administration, even under modern treatment for ACS.

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