Elevated Levels of Oxidative Stress as a Prognostic Predictor of Major Adverse Cardiovascular Events in Patients with Coronary Artery Disease

To evaluate the prognostic significance of oxidative stress on the rate of major adverse cardiovascular events (MACEs: cardiac and all-cause death, nonfatal myocardial infarction, coronary revascularization- PTCA/CABG) in CAD. Methods: We studied 97 angiographically proven CAD patients (78 males, age: 67±11 years, mean± SD). Reactive oxygen metabolites and total antioxidant status, assessed by commercially assays (d-ROMs and OXY-Adsorbent Test; Diacron, Grosseto, GR, Italy), were used to calculate the oxidant/ antioxidant balance. Patient data were collected from the Institute's electronic databank, which saves demographic, clinical, instrumental and follow-up data of all patients admitted to our department. Results: Kaplan-Meier survival estimates showed a significantly worst outcome in patients presenting with elevated oxidative stress levels (>75th percentile, p<0.01). Multivariate Cox models showed that a higher level of oxidative stress was an independent predictor of developing MACEs (hazard ratio = 2.1, confidence intervals 1.2-3.6, p<0.01). Conclusion: Oxidative stress may represent a useful additional tool in the prediction of MACE in CAD.