An oxidative stress score as a combined measure of the pro-oxidant and anti-oxidant counterparts in patients with coronary artery disease

Oxidative stress plays a key role in the pathogenesis and development of atherosclerosis. Aim: To evaluate the relationship between a novel oxidative stress index (reflecting both oxidative and anti-oxidant counterparts) with traditional cardiovascular risk factors and C-reactive protein (CRP) in coronary artery disease (CAD). Methods: 100 angiographically proven CAD and 70 control subjects (mean age: 65±10 years, 110 males), underwent a global cardiovascular risk assessment and serum CRP and oxidative stress estimation. The Oxidative-INDEX was calculated after automated evaluation of serum hydroperoxides and total anti-oxidant capacity (D-ROM and OXY-adsorbent Test, Diacron, Italy) subtracting the OXY standardized variable from the ROM standardized variable. Results: The Oxidative-INDEX was higher in CAD with respect to control subjects (pb0.001). A stepwise elevation in the Oxidative-INDEX levels was found depending on the number of affected vessels (pb0.001). Oxidative stress was elevated according to the presence of diabetes (pb0.001), smoking habit (pb0.01), and hypercholesterolemia (pb0.05). Oxidative-INDEX significantly correlated with aging (p=0.05) and CRP (pb0.001). The Oxidative-INDEX increased with the number of cardiovascular risk factors (pb0.001). After adjustment for traditional CV risk factors, the multivariate logistic regression analysis indicated the Oxidative-INDEX concentration as an independent factor for CAD (odds ratio=1.4, confidence intervals=1.1-1.9, pb0.05). Conclusion: Oxidative stress represents a shared molecular pathway in atherosclerotic-related conditions, and its estimation by the automated Oxidative-INDEX could represent a valuable tool and a promising target in the prevention, diagnosis and treatment of CAD in the clinical setting.