항산화제 투여 후 총 항산화지수 및 사이토카인 변화와 스텐트 재협착에 미치는 영향
The change of serum level of total antioxidant status and cytokine, and in-stent restenosis after supplementation of antioxidant
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적 : 관상동맥질 환자에서 항산화 비타민 C와 E, 항산화제 probucol 병합요법이 스텐트 시술 후 혈중 P-selectin, chemokine, 사이토카인의 농도변화와 스텐트 재협착에 미치는 영향을 연구하였다.방법 : 관상동맥 질환으로 일반 스텐트 시술을 시행한 총 90명의 환자를 항산화제를 복용하지 않은 대조군과 비타민 C와 E, Probucol을 병합 투여한 군으로 나누었으며 이 중 6개월 후 추적관상동맥 조영술을 시행한 환자 71명을 대상으로 비교하였다. 항산화제 치료 전과 6개월 후 혈장내 전체 항산화지수, P-selectin, MCP-1, IL-6과 IL-10을 측정 비교하였고, 6개월 후 관상동맥 조영술을 시행하여 재협착 유무를 조사하였다.결과 : 스텐트 시술 전 임상적 소견, 위험인자, 생화학지표 등은 양 군 간에 유의한 차이가 없었으며 전체 항산화지수, P-selectin, MCP-I, IL-6, IL-10도 양 군 간 유의한 차이가 없었다. 6개월 후 추적검사에서 전체 항산화 지수 P-selectin, MCP-I, IL-6 및 IL-10 역시 양 군 간 유의한 차이가 없었고, 재협착 발생률도 양 군 간 유의한 차이가 없었다.
Abstract
Background : Oxidative stress might be a role in atherosclerosis and increased intake of antioxidant appear to be protective and modify neointimal formation. An antioxidant and probucol prevents endothelial dysfunction and low density lipoprotein oxidation and also inhibits the secretion of cytokine by macrophages. We aimed 1) to study the effects of antioxidant (Vitamin C, E and probucol) supplementation on serum level of antioxidant status (TAS), P-selectin, MCP-1, IL-6 and IL-10 and 2) to investigate the effects of antioxidant intake on in-stent restenosis. Methods : Total 90 patients were assigned to control or antioxidant group (probucol; 500 mg, vitamin C; 1,000 mg, vitamin E; 400 mg). We performed follow up coronary angiography in 35 patients of antioxidant group and 36 patients of control group after 6 months of coronary bare metal stent implantation. We counted the stenotic lesions more than 50% of implanted stent lumen as a restenosis by quantitative coronary angiography. The serum levels of total antioxidant status, P-selectin, MCP-1, IL-6 and IL-10 were measured. Results : The serum levels of total antioxidant status was not elevated in antioxidant group. Antioxidant supplementation did not change the serum levels of P-selectin, MCP-1, IL-6 and IL-10. The 6-month angiographic in-stent restenosis rate was 27% versus 30% (p=NS) with an associated late loss of 0.76±1.01 mm versus 0.91±1.00 mm (p=NS) for antioxidant group and control group. The serum levels of total antioxidant status did not correlate with the restenosis or late loss after stent implantation. Conclusions : Vitamin C, E and probucol did not elevate the serum level of antioxidant status and could not prevent in-stent restenosis after bare metal stent implantation.(Korean J Med 71:158-165, 2006)
참고문헌 (25)
- "Inflammation and atherosclerosis", 105, pp.1135~1143 (2002)
- "Role of oxidative stress in cardiovascular disease", 18, pp.655~673 (2000)
- "Restenosis: the problem and how to deal with it. In: Practical interventional cardiology.", pp.279~294 (2002), Martin Dunits
- "Topol EJ. Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomized trials", 361, pp.2017~2023 (2003)
- "Effect of antioxidant supplementation on the lipid peroxidation and antioxidative enzyme activies in patients with coronary artery disease", 31, pp.1215~1224 (2001)
- "Probucol and multivitamins in the prevention of restenosis after coronary angioplasty: Multivitamins and Probucol Study Group", 337, pp.365~372 (1997)
- "Effecf of probucol on vascular remodeling after coronary angioplasty: Multivitamins and Probucol Study Group", 99, pp.30~35 (1999)
- "Effect of plaque composition on vascular remoldeling after angioplasty in the multivitamins and probucol(MVP) trial", 18, pp.271~275 (2002)
- "Antioxidant nutrient supplementation reduces the susceptibility of low densitiy lipoprotein to oxidation in patient with coronary artery disease", 30, pp.392~399 (1997)
- "Role of vitamin E in preventing the oxidation of low density lipoprotein", 53 (1991)
- "Effect of oral supplementation with D-alpha tocopherol on the vitamin E content of human low density lipoproteins and resistance to oxidation", 32, pp.1325~1332 (1991)
- "The effect of alpha tocopherol and ascorbic acid on the serum lipid peroxide level in elderly people", 28, pp.186~191 (1984)
- "Randomised controlled trial of vitamin E in patients with coronary disease", 347, pp.781~786 (1996)
- "Dietary antioxidants for cardiovascular prevention", 10, pp.38~44 (2000)
- "MRC", BHF: heart protection study of antioxidant vitamin supplementation in 20,536 high-risk induviduals: a randomized placebo-controlled trial., 2002, pp.360, 23~33
- "Vitamin E supplementation and cardiovascular events in high-risk patients", 342, pp.154~160 (2000)
- "Effect of vitamin E and carotene on the incidence of angina pectoris: a randomized, double blind, controlled trial", 275, pp.693~698 (1996)
- "Simvastatin and niacin, antioxidant vitamins or the combination for the prevention of coronary artery disease", 345, pp.1583~1592 (2001)
- "Prevention of restenosis with antioxidants:mechanism and implications", 2, pp.323~334 (2002)
- "Atheroprotective effects of antioxidants through inhibition of mitogen-activation protein kinase", 25, pp.977~985 (2004)
- "The effects of probucol combined with antiplatelets on the coronary stented patients", 30, pp.811~818 (2000)
- "Effects of probucol and cilostazol alon and in combination of frequency of poststenting restenosis", 82, pp.144~147 (1998)
- "Total antioxidants status in plasma and body fluids", 234, pp.279~293 (1994)
- "Monitering of plasma total antioxidants status", 36, pp.188~189 (1997)
- "Serum level of the antiinflamatiory cytokine interleukin-10 is an important prognostic determinant in patient with acute coronary syndrome", 107, pp.2109~2114 (2003)