Sezgin ALBAYRAK, Kemal KARAAĞAÇ, İbrahim BARAN, Zeynel Abidin YETGİN, Hakan UÇAR, Ali AYDINLAR

Akut Miyokard İnfarktüsünde Karvedilol ve Metoprolol’ün Okside LDL ve Paraoksonaz-1 Aktivitesine Erken Dönem Etkisi

Amaç: Bu çalışmanın amacı akut miyokard infarktüsü AMİ geçiren hastalarda dört haftalık karvedilol ve metoprolol tedavisinin okside düşük yoğunluklu lipoprotein LDL düzeyi ve paraoksanaz-1 PON-1 aktivitesi üzerine etkisini araştırmaktır. Yöntem: Çalışmaya AMİ tanısı konulan 31 hasta ve kontrol grubunu oluşturacak 15 olgu alındı. AMİ grubundan 15 hastaya karvedilol ve 16 hastaya metoprolol tedavisi verilerek çalışma iki guruba randomize edildi. Çalışmanın sonunda başvuru ve kontrol vizitinde alınan ve saklanan kan örneklerinden okside LDL’nin ve PON-1 aktivitesinin başvuru tedavi öncesi ve tedavi sonrası 1 aylık sonuçlarına bakıldı. Bulgular: Hasta grubunda kontrol grubuna kıyasla başlangıç HDL düzeyi ve PON-1 aktivitesi anlamlı derecede düşük olarak saptandı. Okside LDL düzeyi hasta grubunda kontrol grubuna göre daha yüksekti. Hasta grubunda 1 aylık karvedilol p=0,008 ve metoprolol p Sonuç: AMİ geçiren hastalarda diğer çalışmalara paralel olarak, okside LDL' nin arttığı ve HDL-K düzeyi ile PON-1 aktivitesinin azaldığı gösterildi. Antioksidan özellikleri nedeniyle Karvedilol’ün PON-1 aktivitesini arttırmada Metoprolol’e göre daha üstün olması beklenebilir. Fakat bir aylık süre bunu göstermek için yeterli olmayabilir.

Anahtar Kelimeler:

Koroner arter hastalığı, okside LDL, paraoksanaz-1

Carvedilol and Metoprolol in Acute Myocardial Infarction Early Effect of Oxidized LDL and Paraoxonase-1 Activity

Objective: The aim of this study to investigate the effects of Carvedilol and Metoprolol on oxidized low density lipoprotein oxLDL and paraoxonase-1 PON-1 activity in patients with acute myocardial infarction who were treated with these agents for four weeks. Method: 31 patients with AMI and 15 healhty subjects for control group were contained. 15 patients of AMI group were given Carvedilol treatment and the remained 16 were given Metoprolol treatment and the study was randomized to two groups. At the end of the study oxLDL and PON-1 activity levels were studied from the blood samples taken at admission pre treatment and samples taken after one month treatment. Results: In patient group initial high density lipoprotein HDL level and PON-1 activity were found significantly lower but oxLDL level was higher in patient group compared to control group. The oxLDL levels were found to decrease in patient group after Carvedilol p=0,008 and Metoprolol p Conclusion: In paralel to other studies we showed that oxLDL is increased and HDL and PON-1 activity is decreased in patients with AMI. Carvedilol may be expected to be superior to Metoprolol due to its antioxidant effect in increasing PON-1 acitvity. But one month period may not be enough to determine this effect.

Keywords:

Coronary Artery Disease, oxidized LDL, paraoxonase-1,

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