The Role of Biochemical Markers of Oxidative Damage in The Progression of Coronary Heart Disease Among Residents of Kirkuk City

Coronary heart disease (CHD) still accounted for a large proportion of all-cause mortality, oxidative stress has been proven to play an important role in the pathogenesis of CHD besides the traditional lipid abnormality. Objective: This work was oriented to the study of oxidative stress biomarkers in CHD patients versus healthy subjects and to investigate the association between these parameters with demographic and clinical variables in Kirkuk City residents in the north of Iraq. A case-control study was conducted on 60 CHD patients (30 males, 30 females; age ranged 40–69 years) and 30 apparently healthy controls (15 males, 15 females; age ranged 40–67 years); all were non-smokers, non-alcoholics, and without hypertension or diabetes. Venous blood samples were taken to estimate malondialdehyde (MDA), glutathione peroxidase (GPx) activity and levels of vitamin C and ceruloplasmin. The independent t test and two-way ANOVA were involved in the statistical analysis. Results: In CHD patients, all OS markers were significantly raised compared with controls, and in patients MDA was significantly higher (4.87 ± 1.23 nmol/mL) than in controls (2.15 ± 0.67 nmol/mL)). Antioxidant defenses were equally severely impaired: GPx activity was decreased (28.64 ± 6.71 U/L vs.58 ± 8.45 U/L), as well as vitamin C levels (0.58 ± 0.21 mg/dl vs. 1.26 ± 0.34 mg/dl) and ceruloplasmin concentrations (28. 93 ± 5.67 mg/dl vs. 41.75 ± 7.82 mg/dl). Gendered analysis showed male patients had greater oxidative imbalance than females. Age stratification showed progressive increase of MDA and decrease of antioxidants with age. Body mass index (BMI) correlated significantly positively with MDA and negatively with antioxidant parameters. Our results indicate an extreme disruption of the oxidant-antioxidant equilibrium in CHD patients with increased lipid peroxidation and impaired antioxidant defense, which indicates that these biomarkers may be of value as additional tools in the risk stratification and follow-up of the disease.