Reactive Oxygen Metabolites are Closely Associated With the Diagnosis and Prognosis of Coronary Artery Disease

Background Reactive oxygen species ( ROS ) are associated with development of coronary artery disease ( CAD ). However, there's no useful biomarker of ROS in CAD . Methods and Results We recruited 395 consecutive CAD patients who were performed coronary angiography (262 male and 133 female, age 70.2±10), and we measured serum derivatives of reactive oxidative metabolites ( DROM ) were measured. Two hundred twenty‐seven non‐ CAD patients were also enrolled. We performed follow‐up study in these 395 CAD patients and case‐control study after risk factor and 1:1 pair matching (both, n=163). As subgroup analysis, DROM were also measured at the aortic root and the coronary sinus in 59 CAD patients. DROM were significantly higher in CAD patients (n=163, median [inter‐quartile range, IQR ]=338 [302 to 386]) than in risk factor‐matched non‐ CAD patients (n=163, 311 [282 to 352.5], effect size=0.33, P <0.001). During a mean follow‐up period of 20 months of 395 CAD patients, 83 cardiovascular events were recorded. Kaplan‐Meier analysis showed a higher probability of cardiovascular events in the high‐ DROM group (>346 U.CARR) than in the low‐ DROM group (≤346 U.CARR) ( P =0.001 [log‐rank test]). Multivariate Cox hazard analysis identified ln‐ DROM as an independent predictor for cardiovascular events (hazard ratio: 10.8, 95% confidence interval: 2.76 to 42.4, P =0.001). The transcardiac gradient of DROM was significantly higher in CAD patients than in non‐ CAD patients (−2.0 [−9.0 to 9.0] versus 8 [−8.0 to 28.3], effect size=0.21, P =0.04), indicating that DROM production in coronary circulation is associated with development of CAD . Conclusion DROM are increased in CAD patients and associated with future cardiovascular events. DROM might provide clinical benefits for risk stratification of CAD . Clinical Trial Registration URL: http://www.umin.ac.jp/ctr/ . Unique identifier: UMIN000012990.