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Oxygen Free Radicals and the Effect of a Free Radical Scavenger in Patients with Intermittent Claudication

4th Department of Internal Medicine, Evangelismos General State Hospital, Athens

Dionisios Charitos

2nd Department of Internal Medicine, Propaedeutic, Athens University Medical School, Evangelismos General State Hospital, Athens

Vassilios Georgopoulos

2nd Department of Internal Medicine, Propaedeutic, Athens University Medical School, Evangelismos General State Hospital, Athens

Emmanuel Economou

Department of Cardiology, Athens University Medical School, Hippokration General State Hospital, Athens

Michael Sfakianakis

Center of Planning and Economic Research, Athens University of Economics, Athens, Greece

Pavlos Toutouzas

Department of Cardiology, Athens University Medical School, Hippokration General State Hospital, Athens

Sotirios Raptis

2nd Department of Internal Medicine, Propaedeutic, Athens University Medical School, Evangelismos General State Hospital, Athens

Oxygen free radicals (OFRs) are implicated in tissue injury during postischemic reperfu sion and play an important role in the pathogenesis of atherosclerosis. In patients with intermittent claudication the ischemia-reperfusion phenomenon could be reproduced after exercise, thus influencing the evolution of chronic peripheral arterial occlusive disease (CPAOD). The aim of this study was to investigate the behavior of OFRs and the effect of a free radical scavenger in patients with stage II_B CPAOD. Malondialdehyde (MDA), a reliable index of OFRs production, was measured in the serum of 19 patients with stage II_B CPAOD and 42 healthy controls. The blood samples were collected from a foot vein in resting condition and during reperfusion after 5 minutes of provoked ischemia. These measurements were repeated after 3 and 12 weeks of oral treatment with the free radical scavenger trimetazidine hydrochloride (60 mg daily). Statistical analysis of the findings revealed that resting MDA was significantly higher in claudicants when compared to the healthy controls (1.247 ±0.25 µmol/L vs 1.021 ±0.278 µmol/L, p<0.005). During postischemic reperfusion (PIR) the MDA levels were significantly increased in claudicants (resting vs PIR: 1.247 ± 0.25 vs 4.60 ± 0.86 µmol/L, p<0.001). The administration of trimetazidine led to a significant reduction of the PIR MDA levels (before treatment 4.60 ±0.86 µmol/L vs 3 weeks 3.93 ±0.63 µmol/L and vs 12 weeks of treatment 2.98 ±0.29 µmol/L, p < 0.001 and p < 0.001, respectively). These findings indicate that claudicants are at increased risk of oxidative damage after exercise. Long- term administration of the free radical scavenger trimetazidine attenuates reperfusion injury in patients with stage II_B CPAOD.

Vascular and Endovascular Surgery, Vol. 34, No. 2, 167-174 (2000)
DOI: 10.1177/153857440003400209


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