Impairment of vascular endothelial function following reperfusion therapy in patients with acute myocardial infarction

Objective

To investigate vascular endothelial impairment as a result of reperfusion therapy in patients with acute myocardial infarction (AMI).

Methods

Patients with AMI underwent reperfusion therapy (percutaneous cardiac intervention [PCI] or thrombolytic therapy) or conservative drug therapy. Healthy control subjects were recruited. Endothelial impairment was assessed via endothelial nitric oxide (NO) synthase (eNOS), NO and endothelin-1 (ET-1) levels, 24 h after reperfusion or on enrolment, as appropriate.

Results

Patients who underwent PCI ( n = 47) or thrombolytic therapy ( n = 45) had significantly lower eNOS and NO levels, and higher ET-1 levels than those who received conservative drug therapy ( n = 46). All patient groups had significantly lower eNOS and NO levels, and higher ET-1 levels, than controls ( n = 45). There was a significant positive correlation between eNOS and NO, as well as significant negative correlations between eNOS/ET-1 and NO/ET-1 in all four groups.

Conclusions

Patients with AMI who underwent reperfusion therapy displayed low eNOS activity. This may result in impairment of endothelial function via downregulation of NO and upregulation of ET-1.