Urinary 8-isoprostane levels can indicate the presence, severity and extent of angiographic coronary artery disease

Background-Atherosclerotic coronary artery disease is the leading cause of death worldwide. Oxidative stress is one of the key elements in the pathogenesis of atherosclerosis. Isoprostanes are established markers of oxidative stress. The aim of this study was to investigate the association of urinary 8-isoprostane levels with the presence and severity of coronary artery disease (CAD) assessed by a validated scoring system. Method-Urinary 8-isoprostane levels were measured in 100 consecutive patients scheduled for coronary angiography. Extent and severity of CAD were assessed by modified Gensini scores. Results-In patients with CAD, 8-isoprostane levels were higher (P < 0.00 1) than in patients without CAD (68.75 +/- 5.5 vs. 38.27 +/- 3.7 pg/ml). The levels of 8-isoprostane correlated with the number of risk factors (P < 0.00 1) and significantly increased in relation with the number of diseased vessels (P < 0.00 1). A significant (P < 0.00 1) correlation was found between 8-isoprostane levels and Gensini scores (r = 0.496), and a stepwise elevation in 8-isoprostane levels was observed across the increasing tertiles of the Gensini scores (P < 0.00 1). The multivariate logistic regression analysis revealed that 8-isoprostane was an independent predictor (odds ratio: 7.19 and P = 0.007) associated with angiographic CAD. Conclusion-These results confirm the role of oxidative stress in the atherosclerotic process. Urinary 8-isoprostane levels reflect the extent and severity of CAD and they may provide additional information for risk assessment in patients with suspected CAD.