Low plasma glutathione levels after reperfused acute myocardial infarction are associated with late cardiac events

Benedetta De Chiara, Antonio Mafrici, Jonica Campolo, Gabriella Famoso, Valentina Sedda, Marina Parolini, Giuliana Cighetti, Alessandro Lualdi, Cesare Fiorentini, Oberdan Parodi

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: To clarify whether an altered redox state persists in the subacute phase of myocardial infarction and if specific redox patterns are associated with later cardiac events. METHODS: Ninety-seven patients [80 men, median 63 (interquartile range, 53, 69) years] with a first acute myocardial infarction, with (53%) or without ST segment elevation, treated with successful percutaneous interventions, were tested at 5-6 days after admission for plasma α-tocopherol, ascorbic acid, total and reduced homocysteine, cysteine, glutathione, cysteinylglycine and blood-reduced glutathione, all assessed by high-pressure liquid chromatography. Free malondialdehyde was evaluated by gas chromatography. A subgroup of 14 patients had adjunctive blood samples within 1 h and at 72 h after angioplasty. Blood samples from 44 patients matched for age, sex, and risk factors served as controls. Patients were followed up for median 15 (interquartile range, 9, 17) months for cardiac events. RESULTS: All plasma-reduced aminothiols, vitamins and plasma total glutathione were significantly lower in myocardial infarction at 5-6 days than in controls. In the 14 myocardial infarction patients sampled repeatedly, plasma-reduced glutathione, cysteinylglycine, total glutathione, and α-tocopherol significantly decreased, whereas blood-reduced glutathione, total homocysteine, and cysteine significantly increased over time. During follow-up, 20 of 97 (21%) patients had adverse cardiac events. Multivariate analysis revealed that only plasma-reduced glutathione was independently associated with events (hazard ratio 0.42, 95% confidence interval 0.18-0.99, P=0.04). CONCLUSIONS: Acute myocardial infarction patients have an altered redox state at 5-6 days after successful reperfusion with respect to controls. Low plasma levels of reduced glutathione at discharge are associated with cardiac events at follow-up.

Original languageEnglish
Pages (from-to)77-82
Number of pages6
JournalCoronary Artery Disease
Issue number2
Publication statusPublished - Mar 2007


  • Acute myocardial infarction
  • Glutathione
  • Oxidative stress
  • Reperfusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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