Association of endothelial nitric oxyde synthase (eNOS) levels and modifiable risk factors for acute myocardial infarction with ST-segment elevation (AMI-STE)
Main Article Content
Abstract
Background. The pathological process underlying myocardial infarction is atherosclerotic thrombosis that causes endothelial dysfunction. In the AMI-STE process, eNOS has functions as the body's defense mechanism to prevent more severe damage to the endothelium. Decreased eNOS levels were found in modifiable AMI risk factors. This study aimed to determine the association of eNOS levels based on modifiable risk factors for AMI-STE patients.
Method. This study was an analytical observational study with a historical cohort design. The samples were patients with AMI-STE diagnosis who had undergone PPCI at M. Djamil Hospital Padang from March to June 2022. The eNOS levels were taken from the blood samples. Modifiable AMI risk factors were taken from patient’s medical record. The T test was carried out to determine statistical analysis.
Results. The average age of the 38 subjects was 62.53 ± 8.2 years, and 92.1% among them were male, and 52.6% subjects were diagnosed with anterior AMI-STE. The average eNOS level in subjects was 47.47 ± 23.88 (normal level is 48.16 pg/mL). More than half (73.5%) of the subjects in low eNOS group had diabetes mellitus as risk factor (P<0.0001) and most subjects (78.9%) in group with low eNOS had hypertension (p=0.022). Other risk factors, namely dyslipidemia and smoking, were also more common in group with low eNOS. However, statistical tests showed that there was no statistically association between eNOS levels with dyslipidemia and smoking.
Conclusion. There was statistically significant association between eNOS levels with diabetes mellitus and hypertension as modifiable risk factors for AMI-STE.
Downloads
Article Details
Copyright (c) 2024 Denada Florencia Leona, Masrul Syafri
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Bhat RR, Schoenike MW, Kowal A, White C, Rouvina J, Hardin CC, et al. Feasibility and Consistency of Results with Deployment of an In-Line Filter for Exercise-Based Evaluations of Patients With Heart Failure During the Novel Coronavirus Disease-2019 Pandemic. J Card Fail. 2021 Jan;27:105–8.
O’Gara B, Subramaniam B, Shaefi S, Mueller A, Banner-Goodspeed V, Talmor D. Anesthetics to Prevent Lung Injury in Cardiac Surgery (APLICS): a protocol for a randomized controlled trial. Trials. 2019 Dec 31;20:312.
Beck EC, Gowd AK, White JC, Knio ZO, O’Gara TJ. The effect of smoking on achieving meaningful clinical outcomes one year after lumbar tubular microdecompression: a matched-pair cohort analysis. Spine J. 2021 Aug;21:1303–8.
Bates ER, Tamis-Holland JE, Bittl JA, O’Gara PT, Levine GN. PCI Strategies in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Coronary Artery Disease. J Am Coll Cardiol. 2016 Sep;68:1066–81.
Adamowicz M, Morgan CC, Haubner BJ, Noseda M, Collins MJ, Abreu Paiva M, et al. Functionally Conserved Noncoding Regulators of Cardiomyocyte Proliferation and Regeneration in Mouse and Human. Circ Genomic Precis Med. 2018 Feb;11:e001805.
Fang L, Moore X-L, Dart AM, Wang L-M. Systemic inflammatory response following acute myocardial infarction. J Geriatr Cardiol. 2015 May;12:305–12.
Mehta SR, Wood DA, Storey RF, Mehran R, Bainey KR, Nguyen H, et al. Complete Revascularization with Multivessel PCI for Myocardial Infarction. N Engl J Med. 2019 Oct 10;381:1411–21.
Chhabra A, Chhabra N, Jain A, Kabi D. Elderly patient’s knowledge, attitudes and behaviors regarding care and maintenance of the removable prosthesis: a qualitative study. Minerva Stomatol. 2015 Dec;64:265–73.
Cziráki A, Lenkey Z, Sulyok E, Szokodi I, Koller A. L-Arginine-Nitric Oxide-Asymmetric Dimethylarginine Pathway and the Coronary Circulation: Translation of Basic Science Results to Clinical Practice. Front Pharmacol. 2020 Sep 29;11.
Abdel Hamid M, Bakhoum SW, Sharaf Y, Sabry D, El‐Gengehe AT, Abdel‐Latif A. Circulating Endothelial Cells and Endothelial Function Predict Major Adverse Cardiac Events and Early Adverse Left Ventricular Remodeling in Patients With ST‐Segment Elevation Myocardial Infarction. J Interv Cardiol. 2016 Feb 11;29:89–98.
Huang PL. eNOS, metabolic syndrome and cardiovascular disease. Trends Endocrinol Metab. 2009 Aug;20:295–302.
Tenopoulou M, Doulias P-T. Endothelial nitric oxide synthase-derived nitric oxide in the regulation of metabolism. F1000Research. 2020 Oct 1;9:1190.
Higashi Y. Endothelial Function in Dyslipidemia: Roles of LDL-Cholesterol, HDL-Cholesterol and Triglycerides. Cells. 2023 May 1;12:1293.
Ardiana M, Susetyo Pikir B, Santoso A, Oky Hermawan H, Jibril Al-Farabi M. The effect of subchronic cigarette smoke exposure on oxidative stress parameters and endothelial nitric oxide synthase in a rat aorta. ARYA Atheroscler. 2021 Jul;17:1–7.
Sastroasmoro S. Dasar-dasar metodologi penelitian klinis. 5th ed. Jakarta: Sagung Seto; 2016.
Bloos SM, Kaur K, Lang K, Gavin N, Mills AM, Baugh CW, et al. Comparing the Timeliness of Treatment in Younger vs. Older Patients with ST-Segment Elevation Myocardial Infarction: A Multi-Center Cohort Study. J Emerg Med. 2021 Jun;60:716–28.
Engberding N, Wenger NK. Acute Coronary Syndromes in the Elderly. F1000Research. 2017 Oct 2;6:1791.
Ekou A, Yao H, Kouamé I, Boni RY, Ehouman E, N’Guetta R. Primary PCI in the management of STEMI in sub-Saharan Africa: insights from Abidjan Heart Institute catheterisation laboratory. Cardiovasc J Afr. 2020 Sep 3;31:39–42.
Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart Disease and Stroke Statistics—2021 Update. Circulation. 2021 Feb 23;143.
Obeidat OS, Makhamreh H, Al-Muhaisen RZ, Obeidat LR, Kitana FI, Amarin JZ, et al. Clinical Characteristics and Prognosis of Young Middle Eastern Adults with ST-Elevation Myocardial Infarction: One-Year Follow-Up. Heart Views. 2021;22:88–95.
Li J-L, Yang Z, Wu S, Kong J. Relationship between Endothelial Nitric Oxide Synthase, Insulin Resistance and Macrovascular Disease in Patients with Acute Myocardial Infarction. J Int Med Res. 2012 Apr 1;40:687–93.
Tasolar H, Eyyupkoca F, Akturk E, Karakus Y, Cansel M, Yagmur J, et al. Endothelial nitric oxide synthase levels and their response to exercise in patients with slow coronary flow. Cardiovasc J Afr. 2013 Dec 4;24:355–9.