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European Heart Journal 1995 16(7):899-902;
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

A late increase in free radical activity post myocardial infarction

A. B. BRIDGES, G. P. MCNEILL*, T. H. PRINGLE* and J. J. F. BELCH

University Departments of Medicine, Ninewells Hospital and Medical School Dundee DDl 9SY, Scotland, U.K.
*University Departments of Cardiology, Ninewells Hospital and Medical School Dundee DDl 9SY, Scotland, U.K.

revised 24 August 1994; accepted 10 November 1994.

Correspondence: Dr A B. Bridges, University Department of Medicine, Stirling Royal Infirmary, Stirling FK8 2AU, Scotland.

Abstract

Free radicals (FR) are a highly reactive chemical species which have been implicated in the pathogenesis of reperfusion injury. Experimental models of reperfusion injury have demonstrated that FR scavengers improve myocardial salvage and thus it has been postulated that they may be of benefit in acute myocardial infarct (MI) patients treated with thrombolysis. Previous studies of FR activity post MI have focused on the immediate post reperfusion period; the present study investigates FR activity in post MI patients over a longer time span.

Free radicals have a very short half-life and in clinical studies their activity is usually assessed indirectly by measuring either the level of FR reaction products such as malondialdehyde (MDA) or FR scavengers such as plasma thiols (PSH). In the presence of increased FR activity MDA levels increase and PSH levels decrease.

Twenty-two acute MI patients had blood samples taken on admission, day 7 and day 21 post MI for measurement of MDA and PSH levels. On day 7 post MI a significant increase in MDA was detected P={theta}0.0001 (Sign test) (median change +{theta}2.1 µmol. I) and a significant decrease was detected in PSH P ={theta} 0.04 (Sign test) (median change, –{theta} 38 µmol. l–{theta}1). No significant differences were detected between admission and day 21 levels of MDA and PSH.

This study demonstrates the presence of enhanced FR activity at a later time point than has previously been recognised. White blood cells utilise FRs during phagocytosis and the late rise in FR activity detected in this study may reflect white blood cell removal of necrotic myocardium.

Key Words: Free radicals • myocardial infarction


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