Abstract | BACKGROUND: METHODS AND RESULTS: A prospective cohort study was conducted in 909 atrial fibrillation patients. Serum activities of GPx3, superoxide dismutase (SOD), and catalase were measured at baseline to assess the risk of cardiovascular events during a mean follow-up of 43.4 months (3291 person-years). Serum Nox2 and urinary excretion of 11-deydro-thromboxane B2 were also measured. During follow-up 160 cardiovascular events occurred (4.9%/year). Significantly lower values of GPx3 (P<0.001) and SOD (P=0.037) were detected in patients with, compared to those without, cardiovascular events. A lower survival rate was observed in patients with GPx3 (P<0.001) and SOD (P=0.010) activities below the median, as compared to those above. In a fully adjusted Cox regression model, GPx3 was the only antioxidant enzyme predictor of cardiovascular events (hazard ratio 0.647, 95% confidence interval 0.524-0.798, P<0.001). GPx3 was inversely associated with urinary 11-dehydro-thromboxane B2 (B -0.337, P<0.001) and serum Nox2 (B: -0.423, P<0.001). GPx3 activity progressively decreased with decades of age (P<0.001), with a progressive reduction in people aged ≥70 years. CONCLUSIONS: This study provides evidence that a low antioxidant status, as depicted by reduced levels of GPx3, increases the risk of cardiovascular events in patients with atrial fibrillation. The age-related decline of GPx3 may represent a mechanism for the enhanced cardiovascular risk in the elderly population.
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Authors | Daniele Pastori, Pasquale Pignatelli, Alessio Farcomeni, Danilo Menichelli, Cristina Nocella, Roberto Carnevale, Francesco Violi |
Journal | Journal of the American Heart Association
(J Am Heart Assoc)
Vol. 5
Issue 9
(09 08 2016)
ISSN: 2047-9980 [Electronic] England |
PMID | 27609361
(Publication Type: Journal Article)
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Copyright | © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. |
Chemical References |
- Thromboxane B2
- 11-dehydro-thromboxane B2
- GPX3 protein, human
- Catalase
- Glutathione Peroxidase
- Superoxide Dismutase
- CYBB protein, human
- NADPH Oxidase 2
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Topics |
- Aged
- Aged, 80 and over
- Aging
(metabolism)
- Atrial Fibrillation
(epidemiology, metabolism)
- Cardiovascular Diseases
(epidemiology, metabolism, mortality)
- Catalase
(metabolism)
- Cohort Studies
- Female
- Follow-Up Studies
- Glutathione Peroxidase
(metabolism)
- Humans
- Ischemic Attack, Transient
(epidemiology, metabolism)
- Male
- Middle Aged
- Myocardial Infarction
(epidemiology, metabolism)
- Myocardial Revascularization
(statistics & numerical data)
- NADPH Oxidase 2
(blood)
- Prognosis
- Proportional Hazards Models
- Prospective Studies
- Stroke
(epidemiology, metabolism)
- Superoxide Dismutase
(metabolism)
- Thromboxane B2
(analogs & derivatives, urine)
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