Curcumin’s Antioxidant Properties in Stable Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention: A Randomized Controlled Trial

Todung Silalahi, Idrus Alwi, Frans Suyatna, Katarina Dewi Sartika, Christopher Surya Suwita

Abstract


BACKGROUND: Percutaneous coronary intervention (PCI) is the most common intervention for coronary artery disease (CAD) with very low complications. High oxidative stress post-PCI is associated with further atherosclerosis progression. Curcumin, extracted from a specific type of herbs, exhibits anti-oxidant properties by acting as hydrogen and electron donor for superoxide radicals. The aim of this study is to determine the effect of curcumin’s antioxidant properties in reducing oxidative stress of post-PCI in stable CAD.

METHODS: This study was a double-blind parallel randomized controlled trial among 50 stable CAD patients undergoing PCI in Cipto Mangunkusumo General Hospital and Jakarta Heart Center. The subjects received either 45 mg/day curcumin or placebo 7 days pre-PCI until 48 hours post-PCI. Reduced oxidative stress markers (decreased MDA or increased GSH) were measured in 3 phases (7 days pre-PCI, 24 hours post-PCI, 48 hours post-PCI).

RESULTS: Curcumin group showed increased MDA from baseline to 24 hours (Δ1=0.01 vs. 0.03; p=0.3) and decreased MDA from baseline to 48 hours (Δ2=-0.06 vs. 0.03; p=0.9). While, curcumin group showed decreased GSH from baseline to 24 hours (Δ1=-49.7% vs. 12.2%; p=0.4) and from baseline to 48 hours (Δ2=-19.09% vs. 11.4%; p=0.6). However, no significant changes were found in malondialdehide (MDA) and glutathione (GSH) level after the intervention.

CONCLUSION: The 45 mg/day curcumin supplementation from 7 days pre-PCI until 48 hours post-PCI had no significant antioxidant effect in stable CAD post-PCI.

KEYWORDS: coronary artery disease, curcumin, antioxidant, percutaneous coronary intervention


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References


World Health Organization. Global health estimates: Leading causes of DALYs. Disease burden, 2000–2019 [cited Jul 1, 2021]. Available from: https://www.who.int/.

Kementrian Kesehatan RI. Basic Health Research 2013. Jakarta; Kementrian Kesehatan RI; 2013, article.

Gruntzig A. Transluminal dilatation of coronary-artery stenosis. Lancet. 1978; 1(8058): 263, CrossRef.

Means G, End C, Kaul P. Management of percutaneous coronary intervention complications. Curr Treat Options Cardiovasc Med. 2017; 19(4): 25, CrossRef.

Cicek D, Tamer L, Pekdemir H. Coronary angioplasty induced oxidative stress and its relation with metoprolol use and plasma homocysteine levels. Anadolu Kardiyol Derg. 2006; 6(4): 308-13, PMID.

Ferns GA, Raines EW, Sprugel KH. Inhibition of neointimal smooth muscle accumulation after angioplasty by an antibody to PDGF. Science. 1991; 253(5024): 1129-32, CrossRef.

Holmes DR, Vlietstra RE, Smith HC. Restenosis after percutaneous transluminal coronary angioplasty (PTCA): a report from the PTCA Registry of the National Heart, Lung, and Blood Institute. Am J Cardiol. 1984; 53(12): 77C-81C, CrossRef.

Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation. 2011; 124(23): e574-651, CrossRef.

Nobuyoshi M, Kimura T, Nosaka H. Restenosis after successful percutaneous transluminal coronary angioplasty: serial angiographic follow-up of 229 patients. J AM Coll Cardiol. 1988; 12(3): 616-23, CrossRef.

Serruys P, Lutijen H, Beatt K, Geuskens R, Feyter Pd, Brand Mvd. Incidence of restenosis after successful coronary angioplasty: a time-related phenomenon. A quantitative angiographic study in 342 consecutive patients at 1, 2, 3, and 4 months. Circ J. 1988; 77(2): 361-71, CrossRef.

Kapakos G, Youreva V, Srivastava AK. Cardiovascular protection by curcumin: molecular aspects. Indian J Biochem Biophys. 2012; 49(5): 306-15, PMID.

Sreejayan N, Rao MN. Free radical scavenging activity of curcuminoids. Arzneimittelforschung. 1996; 46(2): 169-71, PMID.

Jain SK, Rains J, Croad J, Larson B, Jones K. Curcumin supplementation lowers TNF-alpha, IL-6, IL-8, and MCP-1 secretion in high glucose-treated cultured monocytes and blood levels of TNF-alpha, IL-6, MCP-1, glucose, and glycosylated hemoglobin in diabetic rats. Antioxid Redox Signal. 2009; 11(2): 241-9, CrossRef.

Wasserfuhr D, Cetin SM, Yang J, Freitag P, Frede S, Jakob H, et al. Protection of the right ventricle from ischemia and reperfusion by preceding hypoxia. Naunyn Schmiedebergs Arch Pharmacol. 2008; 378(1): 27-32, CrossRef.

Cheng AL HC, Lin JK, Hsu MM, Ho YF, Shen TS. Phase I clinical trial of curcumin, a chemopreventive agent, in patients with high-risk or pre-malignant lesions. Anticancer Res. 2001; 21(4B): 2895-900, PMID.

Lao CD, Ruffin MTt, Normolle D, Heath DD, Murray SI, Bailey JM, et al. Dose escalation of a curcuminoid formulation. BMC Complement Altern Med. 2006; 6: 10, CrossRef.

Sharma RA, McLelland HR, Hill KA, Ireson CR, Euden SA, Manson MM, et al. Pharmacodynamic and pharmacokinetic study of oral Curcuma extract in patients with colorectal cancer. Clin Cancer Res. 2001; 7(7): 1894-900, PMID.

Ozer MK, Parlakpinar H, Cigremis Y. Ischemia-reperfusion leads to depl etion of glutathione content and augmentation of malondialdehyde production in the rat heart from overproduction of oxidants: can caffeic acid phenethyl est er (CAPE) protect the heart? Mol Cell Biochem. 2005; 273(1-2): 169-75, CrossRef.

Roberts MJ, Young IS, Trouton TG, Trimble ER, Khan MM, Webb SW, et al. Transient release of lipid peroxides after coronary artery balloon angioplasty. Lancet. 1990; 336(8708): 143-5, CrossRef.

Kim TH, Jiang HH, Youn YS, Park CW, Tak KK, Lee S, et al. Preparation and characterization of water-soluble albumin-bound curcumin nanoparticles with improved antitumor activity. Int J Pharm. 2011; 403(1-2): 285-91, CrossRef.

Murrow JR, Sher S, Ali S, Uphoff I, Patel R, Porkert M, et al. The differential effect of statins on oxidative stress and endothelial function: atorvastatin versus pravastatin. J Clin Lipidol. 2012; 6(1): 42-9, CrossRef.

Pytel E, Jackowska P, Chwatko G, Olszewska-Banaszczyk M, Koter-Michalak M, Kubalczyk P, et al. Intensive statin therapy, used alone or in combination with ezetimibe, improves homocysteine level and lipid peroxidation to a similar degree in patients with coronary artery diseases. Pharmacol Rep. 2016; 68(2): 344-8, CrossRef.

Kopff M, Kowalczyk E, Kopff A. Influence of selected cardiological drugs on oxidative status. Pol J Pharmacol. 2004; 56(2): 265-9, PMID.

Buffon A, Santini SA, Ramazzotti V. Large, sustained cardiac lipid pero xidation and reduced antioxidant capacity in the coronary circulation after brie f episodes of myocardial ischemia. J AM Coll Cardiol. 2000; 35(3): 633-9, CrossRef.

Iuliano L, Pratico D, Greco C, Mangieri E, Scibilia G, FitzGerald GA, et al. Angioplasty increases coronary sinus F2-isoprostane formation: evidence for in vivo oxidative stress during PTCA. J Am Coll Cardiol. 2001; 37(1): 76-80, CrossRef.

Hollman PC, Cassidy A, Comte B, Heinonen M, Richelle M, Richling E, et al. The biological relevance of direct antioxidant effects of polyphenols for cardiovascular health in humans is not established. J Nutr. 2011; 141(5): 989s-1009s, CrossRef.

Alp H, Aytekin I, Hatipoglu NK, Alp A, Ogun M. Effects of sulforophane and curcumin on oxidative stress created acute malathion toxicity in rats. Eur Rev Med Pharmacol Sci. 2012; 16(Suppl 3): 144-8, PMID.

Kuyumcu F, Aycan A. Evaluation of oxidative stress levels and antioxidant enzyme activities in burst fractures. Med Sci Monit. 2018; 24: 225-34, CrossRef.

Cheng SB, Liu HT, Chen SY, Lin PT, Lai CY, Huang YC. Changes of oxidative stress, glutathione, and its dependent antioxidant enzyme activities in patients with hepatocellular carcinoma before and after tumor resection. PLoS One. 2017; 12(1): e0170016, CrossRef.

Szewczyk-Golec K, Grzelakowski P, Ługowski T, Kędziora J. The effects of percutaneous transluminal coronary intervention on biomarkers of oxidative stress in the erythrocytes of elderly male patients. Redox Rep. 2017; 22(6): 315-22, CrossRef.

Sukardi R, Sastroasmoro S, Siregar NC, Djer MM, Suyatna FD, Sadikin M, et al. The role of curcumin as an inhibitor of oxidative stress caused by ischaemia re-perfusion injury in tetralogy of Fallot patients undergoing corrective surgery. Cardiol Young. 2015: 26(3), 431-8, CrossRef.




DOI: https://doi.org/10.18585/inabj.v14i1.1734

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