Abstract 15275: Effectiveness of Combination of Intracellular and Extracellular Aminothiols for Prediction of Cardiovascular Events
Backgrounds: Disulfide bonds are formed from the oxidation of sulfhydryl (-SH) groups such as glutathione disulfide (GSSH) from glutathione (GSH), cystine from cysteine. The aminothiols indicate oxidative stress. But, the difference has not been fully investigated.
Hypothesis: Combination of GSSG in red blood cells (RBC) and serum total cysteine (tCys) comprising mainly cystine may predict cardiovascular events.
Methods: 255 patients with cardiovascular disease (65±13 y/o) were prospectively followed up for 2.68±1.47 years. An oxidative stress test of d-ROMs was also performed.
Results: In the follow-up, there were 8 (3%) of cardiovascular deaths, 12 (5%) of MACEs, 47 (18%) of cardiovascular events (MACEs plus hospitalization for heart failure, cardiovascular surgery, revascularization). There was a weak correlation between GSSG and tCys (r=0.167), but neither of them was associated with d-ROMs. tCys was negatively correlated to eGFR (r=-0.350). We classified the patients into four groups with combining the medians as cut-off points (tCys: 165.20 μM, GSSG: 34.61 μM); Group I (number of pts.=72): low tCys and low GSSG, Group II (57): high tCys and low GSSG, Group III (57): low tCys and high GSSG, Group IV (69): high tCys and high GSSG. Kaplan-Meier curves showed that Group II, IV had significantly higher rates of cardiovascular events and Group III tended to increase cardiovascular events (log-rank; p=0.050) (Figure). In univariate COX analysis, hazard ratios (HR) with setting Group I as reference were Group II 3.094 (CI 1.089-8.792, p=0.034), Group III 3.025 (CI 1.012-9.040, p=0.047), Group IV 5.210 (CI 1.962-13.830, p=0.001). After adjustment for age, sex, coronary risk factors, CRP, eGFR, d-ROMs, Group III, IV remained in high risk; Group III 3.598 (CI 1.183-10.945, p=0.024), Group IV 3.646 (CI 1.294-10.277, p=0.014).
Conclusions: tCys partially depended on renal function, but GSSG did not. The combination was useful to stratify further cardiovascular risks.
Author Disclosures: N. Masaki: None. B. Takase: None. T. Adachi: None.
- © 2016 by American Heart Association, Inc.