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European Heart Journal 1999 20(18):1314-1317; doi:10.1053/euhj.1999.1527
Copyright © 1999 by the European Society of Cardiology.
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Decreased melatonin synthesis in patients with coronary artery disease

A. Sakotnika, P.M. Liebmannb,f1, K. Stoschitzkyc, P. Lercherc, K. Schauensteinb, W. Kleina and B. Ebera

a II Medical Department, General Hospital Wels, Wels
b Department of General and Experimental Pathology, Karl-Franzens-University of Graz, Graz
c Department of Internal Medicine, Division of Cardiology, Karl-Franzens-University of Graz, Graz, Austria

revised January 8, 1999; accepted January 15, 1999

Abstract

Aims Decreased night-time plasma levels of melatonin were recently reported in patients with coronary artery disease, and it was postulated that melatonin production may be impaired, due to a lack of synthesizing enzymes. However, since artefacts possibly influencing the release pattern were not taken into account, this interpretation was strongly criticized. We therefore carefully investigated night-time melatonin production in patients with coronary artery disease using an appropriate experimental approach. Furthermore, we examined the effect of beta-blockers, a frequently used drug in coronary artery disease therapy.

Methods and Results Forty-eight male patients with angiographically documented severe coronary artery disease, 24 of them taking beta-blockers daily in therapeutic dosages, were included. Eighteen age-matched men, with no evidence of coronary sclerosis, served as controls. To determine melatonin production, 6-sulfatoxymelatonin (aMT6s) was measured radioimmunologically from overnight urine. Urinary aMT6s concentration was significantly decreased in patients, and beta-blocker treatment did not further suppress melatonin production.

Conclusions The data obtained using this investigative approach provide clearcut evidence that melatonin production in patients with coronary artery disease is decreased. Whether a decreased melatonin level may be a predisposing factor for coronary artery disease, or whether the occurrence of coronary artery disease decreases melatonin synthesis remains to be determined.

Key Words: Melatonin, coronary artery disease, antioxidants, atherosclerosis, low density lipoprotein

f1 Correspondence : Dr Peter M. Liebmann, Dept. of General and Experimental Pathology, University of Graz, Heinrichstraße 31, A-8010 Graz, Austria.


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