High-dose antioxidant therapy during thrombolysis in patients with acute myocardial infarction

This study investigated the effects of 24-hour intravenous infusion of glutathione (GSH) on plasma malondialdehyde (MDA) levels and on clinical recovery after myocardial infarction in 67 patients treated with recombinant tissue-type plasminogen activator (rt-PA) and 29 patients not given rt-PA. Baseline MDA levels were also measured in 20 healthy control subjects matched for sex, age, and smoking habits. Administration of rt-PA resulted in an earlier recovery of ST elevation. A higher number of patients with fast ST recovery, a lower creatine phosphokinase (CPK) maximum peak, earlier CPK peak, and a lower incidence of arrhythmic episodes were among those who received GSH in addition to rt-PA. Patients who did not receive rt-PA showed a rather steady trend of plasma MDA levels. Patients receiving thrombolytic therapy showed increased MDA concentrations beginning 6 hours after starting therapy. However, while the patients treated only with rt-PA showed a continuous increase in MDA levels, those patients who also received GSH had a significant decrease in MDA levels. Plasma MDA levels significantly increased after thrombolysis; administration of GSH appeared to limit some adverse effects associated with reperfusion-induced oxidative stress.