The impact of alpha lipoic acid administration on oxidative stress markers and occurrence of no-reflow phenomenon in post myocardial infarction patients
Abstract Background Primary percutaneous coronary intervention (PPCI) is the treatment of choice for ST-segment-elevation myocardial infarction (STEMI). Post-PCI induced-oxidative stress, a complication of PCI, is linked to the no-reflow (NR) phenomenon and poor prognosis. A clinical trial involving...
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SpringerOpen
2025-05-01
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| Series: | Future Journal of Pharmaceutical Sciences |
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| Online Access: | https://doi.org/10.1186/s43094-025-00805-7 |
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| author | Omar R. Elsayed Lamia Mohamed El Wakeel Mohamed Ayman Saleh Marwa Adel Ahmed |
| author_facet | Omar R. Elsayed Lamia Mohamed El Wakeel Mohamed Ayman Saleh Marwa Adel Ahmed |
| author_sort | Omar R. Elsayed |
| collection | DOAJ |
| description | Abstract Background Primary percutaneous coronary intervention (PPCI) is the treatment of choice for ST-segment-elevation myocardial infarction (STEMI). Post-PCI induced-oxidative stress, a complication of PCI, is linked to the no-reflow (NR) phenomenon and poor prognosis. A clinical trial involving 70 STEMI patients was conducted to evaluate the impact of alpha lipoic acid (ALA), an antioxidant and anti-inflammatory agent, on oxidative stress and NR. The participants were randomized to standard care (control group) or 600 mg IV infusion of ALA pre/peri PPCI then 600 mg orally once for 28 days plus standard care (ALA group). Outcomes included the degree of myocardial reperfusion by thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade (MBG), Aldehyde dehydrogenase 2 (ALDH2) and Paroxonase 1 (PON-1) levels, also left ventricular ejection fraction (LVEF), and major adverse cardiac events (MACE). Results TIMI flow grade-3 and MBG grade-3 were significantly higher in the ALA group versus controls (97.1% and 62.9%, respectively, P = 0.001, 82.9%, and 45.7%, respectively, P = 0.002). ALDH2 and PON-1 levels were significantly higher in ALA versus controls post-PPCI at all-time points (24 h and 7 days). The ALA group exhibited better LVEF at 7 and 28 days when compared to controls. Conclusion ALA supplementation decreased the occurrence of NR, reduced myocardial ischemia–reperfusion injury (IRI) post-PPCI, increased ALDH2, and PON-1 levels, and improved LVEF. |
| format | Article |
| id | doaj-art-d3a2d9fed7624adab8da1f987b17ee41 |
| institution | DOAJ |
| issn | 2314-7253 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SpringerOpen |
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| series | Future Journal of Pharmaceutical Sciences |
| spelling | doaj-art-d3a2d9fed7624adab8da1f987b17ee412025-08-20T03:09:34ZengSpringerOpenFuture Journal of Pharmaceutical Sciences2314-72532025-05-0111111310.1186/s43094-025-00805-7The impact of alpha lipoic acid administration on oxidative stress markers and occurrence of no-reflow phenomenon in post myocardial infarction patientsOmar R. Elsayed0Lamia Mohamed El Wakeel1Mohamed Ayman Saleh2Marwa Adel Ahmed3Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams UniversityClinical Pharmacy Department, Faculty of Pharmacy, Ain Shams UniversityDepartment of Cardiology, Faculty of Medicine, Ain Shams UniversityClinical Pharmacy Department, Faculty of Pharmacy, Ain Shams UniversityAbstract Background Primary percutaneous coronary intervention (PPCI) is the treatment of choice for ST-segment-elevation myocardial infarction (STEMI). Post-PCI induced-oxidative stress, a complication of PCI, is linked to the no-reflow (NR) phenomenon and poor prognosis. A clinical trial involving 70 STEMI patients was conducted to evaluate the impact of alpha lipoic acid (ALA), an antioxidant and anti-inflammatory agent, on oxidative stress and NR. The participants were randomized to standard care (control group) or 600 mg IV infusion of ALA pre/peri PPCI then 600 mg orally once for 28 days plus standard care (ALA group). Outcomes included the degree of myocardial reperfusion by thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade (MBG), Aldehyde dehydrogenase 2 (ALDH2) and Paroxonase 1 (PON-1) levels, also left ventricular ejection fraction (LVEF), and major adverse cardiac events (MACE). Results TIMI flow grade-3 and MBG grade-3 were significantly higher in the ALA group versus controls (97.1% and 62.9%, respectively, P = 0.001, 82.9%, and 45.7%, respectively, P = 0.002). ALDH2 and PON-1 levels were significantly higher in ALA versus controls post-PPCI at all-time points (24 h and 7 days). The ALA group exhibited better LVEF at 7 and 28 days when compared to controls. Conclusion ALA supplementation decreased the occurrence of NR, reduced myocardial ischemia–reperfusion injury (IRI) post-PPCI, increased ALDH2, and PON-1 levels, and improved LVEF.https://doi.org/10.1186/s43094-025-00805-7Alpha lipoic acidNo-reflowIschemic reperfusion injuryALDH2PON1 |
| spellingShingle | Omar R. Elsayed Lamia Mohamed El Wakeel Mohamed Ayman Saleh Marwa Adel Ahmed The impact of alpha lipoic acid administration on oxidative stress markers and occurrence of no-reflow phenomenon in post myocardial infarction patients Future Journal of Pharmaceutical Sciences Alpha lipoic acid No-reflow Ischemic reperfusion injury ALDH2 PON1 |
| title | The impact of alpha lipoic acid administration on oxidative stress markers and occurrence of no-reflow phenomenon in post myocardial infarction patients |
| title_full | The impact of alpha lipoic acid administration on oxidative stress markers and occurrence of no-reflow phenomenon in post myocardial infarction patients |
| title_fullStr | The impact of alpha lipoic acid administration on oxidative stress markers and occurrence of no-reflow phenomenon in post myocardial infarction patients |
| title_full_unstemmed | The impact of alpha lipoic acid administration on oxidative stress markers and occurrence of no-reflow phenomenon in post myocardial infarction patients |
| title_short | The impact of alpha lipoic acid administration on oxidative stress markers and occurrence of no-reflow phenomenon in post myocardial infarction patients |
| title_sort | impact of alpha lipoic acid administration on oxidative stress markers and occurrence of no reflow phenomenon in post myocardial infarction patients |
| topic | Alpha lipoic acid No-reflow Ischemic reperfusion injury ALDH2 PON1 |
| url | https://doi.org/10.1186/s43094-025-00805-7 |
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