The Effect Of Serum Paraoxonase-1 Enzyme Activity On The Coronary Stent Restenosis


Thesis Type: Expertise In Medicine

Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey

Approval Date: 2020

Thesis Language: Turkish

Student: ESRA KANSU DİNÇ

Supervisor: MUSTAFA CEMRİ

Abstract:

PCI, although used prevalently in the treatment of coronary artery disease, restenosis, the response of the vessel to recovery against trauma, reduces the long-term success of this method. With increased usage of stents, ISR has become a more important problem. Pathophysiologic factors in stent restenosis have not been fully enlightened, even though it is known that there is a negative correlation between HDL cholesterol levels and stent restenosis. PON1, prevents atherosclerosis by protecting LDL and HDL from oxidation and controls oxidative stress that occurs after angioplasty in smooth muscle cells. ISR is a significant clinical problem that increases mortality and morbidity. For this reason, predictability of restenosis is an important issue, since new treatment strategies can be developed. There are few number of studies analyzing the relationship between PON1 enzyme activity and stent restenosis. In the light of this information, in our study we aim to explore the relationship between PON1 enzyme activity and ISR development. In our study, 70 patients with stable CAD who had previously undergone coronary stent implantation were included. ISR developing 35 patients were included in restenosis group; remaining 35 patients who did not develop ISR were included in control group. PON1 enzyme activity was measured spectrophotometrically. 84 PON1 enzyme activity was measured significantly lower in patients who developed ISR compared to patients who did not. Additionally, as PON1 enzyme activity increased, a significant decrease was observed in ISR detected patient ratio. Stent type and white blood cell count were observed as independent determinants in stent restenosis. Statin use was observed to be significantly lower in the ISR developing group compared to the control group. Besides, as PON1 enzyme activity increased a significant increase in statin usage rate and a significant decrease in non HDL cholesterol level were observed. PON1 enzyme activity is shown to be significantly negatively correlated with hemoglobin, LDL cholesterol, triglyceride, total cholesterol, VLDL cholesterol and non HDL cholesterol. Results of our study in which we researched the relationship between serum PON1 enzyme activity and ISR development show that decreased PON1 enzyme activity may play a role in ISR development.