Arylesterase activity of Paraoxonase 1 - prognostic factor for one-year survival in patients with acute myocardial infarction

Open access

Abstract

Introduction: Reduced serum levels of paraoxonase 1 (PON1) activities are associated with diseases involving increased oxidative stress, such as acute coronary syndrome. We aimed to determine whether serum PON1 activities are a prognostic factor for one-year survival following ST-elevation myocardial infarction (STEMI).

Material and methods: We prospectively followed for one-year 75 patients diagnosed and treated for STEMI. Clinical, laboratory and imagistic data were gathered after coronary angiography. PON1 activities (paraoxonase, arylesterase, and lactonase) were assayed spectophotometrically on samples of heparinized plasma taken from the patients in a timeframe of maximum 20 minutes after coronary angiography.

Results: Increased mortality was linked to age (patients over 68 years), permanent atrial fibrillation or left ventricular ejection fraction (LVEF) <40% (associated with global hypokinesia, apical or septal akinesia), trivascular disease atherosclerosis, reduced PON1 activities (paraoxonase <18.4 IU/mL, arylesterase <12.6 IU/mL, lactonase <27.6 IU/mL), and glomerular filtration rate levels <54 mL/min/1.73m2. Multivariate survival analysis showed the independent prognostic role of age (HR 3.92; 95%CI 1.08-14.16; p=0.03), LVEF (HR 9.93; 95%CI 2.20-44.86; p=0.003) and arylesterase (HR 4.25; 95%CI 0.94-19.18; p=0.05) for one-year mortality.

Conclusion: Reduced arylesterase activity of PON1 is an independent predictor of one-year survival after acute myocardial infarction.

1. She Z, Chen H, Yan Y, Li H, Liu D. The human paraoxonase gene cluster as a target in the treatment of atherosclerosis. Antioxid Redox Signal 2012;16(2):597-632. DOI: 10.1089/ars.2010.3774

2. Pyati AK, Halappa CK, Pyati SA, Nagaraj, Wali V. Serum basal paraoxonase 1 activity as an additional liver function test for the evaluation of patients with chronic hepatitis. J Clin Diagn Res 2015;9(11):12-15. DOI: 10.7860/JCDR/2015/15917.6850

3. Audikovszky M, Pados P, Seres I, Harangi M, Fulop P, Katona E, et al. Orlistat increases serum paraoxonase activity in obese patients. Nutr Metab Cardiovasc Dis 2007;17:268-73. DOI: 10.1016/j.numecd.2006.03.004

4. James RW, Deakin SP. The contribution of high density lipoprotein apolipoproteins and derivatives to serum paraoxonase-1 activity and function. Adv Exp Med Biol 2010;660:173-81. DOI: 10.1007/978-1-60761-350-3_16

5. Kulka M. A review of paraoxonase 1 properties and diagnostic applications. Pol J Vet Sci 2016;19(1):225-32. DOI: 10.1515/pjvs-2016-0028

6. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics – 2015 update: a report from the American Heart Association. Circulation 2015;131(4):e29-e32. DOI: 10.1161/CIR.0000000000000152

7. Ho E, Karimi Galougahi K, Liu CC, Bhindi R, Figtree GA. Biological markers of oxidative stress: Applications to cardiovascular research and practice. Redox Biol 2013;1:483-91. DOI: 10.1016/j.redox.2013.07.006

8. Iliesiu A, Campeanu A, Marta D, Parvu I, Gheorghe G. Uric Acid, Oxidative Stress and Inflammation in Chronic Heart Failure with Reduced Ejection Fraction. Rev Romana Med Lab. 2015;23(4):397-405. DOI: 10.1515/rrlm-2015-0039

9. Khalil A, Kamtchueng SO, Ikhlef S, Berrougui H. The role of paraoxonase 1 in regulating high-density lipo-protein functionality during aging. Can J Physiol Pharmacol 2017;95(10):1254-62. DOI: 10.1139/cjpp-2017-0117

10. Bounafaa A, Berrougui H, Ikhlef S, Essamadi A, Nasser B, Bennis A, et al. Alteration of HDL functionality and PON1 activities in acute coronary syndrome patients. Clin Biochem 2014;47(18):318-25. DOI: 10.1016/j.clinbiochem.2014.09.001

11. Nagarajan A, Abirami S, Sivaraj I, Amarnath G, Swathine C, Devi A. L55M and Q192R polymorphism pf paraoxonase gene and the risk of myocardial infarction in South Indian Tamil population. Meta Gene 2017. DOI: 10.1016/j.mgene.2017.11.004

12. Iqbal MP, Khan AH, Mehboobali N, Iqbal SP. Human paraoxonase and HDL-Cholesterol in Pakistani patients with acute myocardial infarction and normal healthy adults. Pak J Med Sci 2007;23:659-64.

13. Wang X, Fan Z, Huang J, Su S, Yu Q, Zhao J, et al. Extensive association analysis between polymorphisms of PON gene cluster with coronary heart disease in Chinese Han population. Ather Thromb Vasc Biol 2003;23:328-34. DOI: 10.1161/01.ATV.0000051702.38086.C1

14. Mackness B, Mackness MI, Durrington PN, Arrol S, Evans AE, McMaster D, et al. Paraoxonase activity in two healthy populations with differing rates of coronary heart disease. Eur J Clin Invest 2000;30:4-10. DOI: 10.1046/j.1365-2362.2000.00580.x

15. Ilea I, Lupan I, Leucuta DC, Duncea CR, Dronca M. The number of PON1 mutant alleles, but not PON1 phenotype, is associated with Gensini score of coronary damage. Rev Romana Med Lab. 2013;21(4):391-8. DOI: 10.2478/rrlm-2013-0042

16. Ciumarnean L, Milaciu MV, Macarie AE, Sampelean DP, Achimas-Cadariu A. Non-genetic factors influencing serum PON1 levels. HVM Bioflux 2014;6(1):20-24.

17. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ 2015;351:5527. DOI: 10.1136/bmj.h5527

18. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. Circulation 2012;33:2551-67.

19. Steg G, James SK, Atar D, Badano LP, Blom-strom-Lundkvist C, Borger MA, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J 2012;33(20):2569-619. DOI: 10.1093/eurheartj/ehs215

20. Eagle K, Lim MJ, Dabbous OH, Pieper KS, Goldberg RJ, Van De Werf F, et al. A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-months postdischarge death in an international registry. J Am Med Assoc 2004;291(22):2727-33. DOI: 10.1001/jama.291.22.2727

21. GRACE 2.0 ACS Risk Calculator. Available at: http://www.gracescore.org/WebSite/WebVersion.aspx. Accessed December 4, 2017.

22. Chengode S. Left ventricular global systolic function assessment by echocardiography. Ann Cardiac Anaesth 2016;19(1):S26-S34. DOI: 10.4103/0971-9784.192617

23. Kettler M, Wanner C. Chronic Kidney Disease - Update 2018. Dtsch Med Wochenschr 2018;143(3):169-73. DOI: 10.1055/s-0043-124831

24. Eckerson HW, Wyte CM, La Du BN. The human serum paraoxonase/arylesterase polymorphism. Am J Hum Genet 1983;35:1126-38.

25. Chapman E, Wong CH. A pH sensitive colorimetric assay for the high-throughout screening of enzyme inhibitors and substrates: a case study using kinases. Bio-organic Med Chem 2002;10(3):551-5. DOI: 10.1016/S0968-0896(01)00306-6

26. Khersonsky O, Tawfik D. Structure-reactivity studies of serum paraoxonase PON1 suggest that its native activity is lactonase. Biochem 2005;44:6371-82. DOI: 10.1021/bi047440d

27. MedCalc Software bvba, Ostend, Belgium. Available at: http://www.medcalc.org. Accessed December 4, 2017.

28. Fox KA, Dabbous OH, Goldberg RJ, Pieper KS, Eagle KA, Van De Werf F, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome (GRACE). BMJ 2006;333:1091. DOI: 10.1136/bmj.38985.646481.55

29. Mukherjee J, Beshansky JR, Ruthazer R, Alkofide H, Ray M, Kent D, et al. In-hospital measurement of left ventricular ejection fraction and one-year outcomes in acute coronary syndromes: results from the IMMEDIATE trial. J Cardiovasc Ultrasound 2015;14:29. DOI: 10.1186/s12947-016-0068-1

30. Peyracchia M, Scacciatella P, Conrotto F, Meynet I, Biava LM, Budano C, et al. Impact of chronic kidney disease on mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. A long-term single-center mortality study. Minerva Cardioangiologica 2018;66(1):6-15.

31. Lee WC, Fang HY, Chen HC, Chen CJ, Yang CH, Hang CL, et al. Anemia : A significant cardiovascular mortality risk after ST – segment elevation myocardial infarction complicated by the comorbidities of hypertension and kidney disease. PLos ONE 2017; 12(7);e0180165. DOI: 10.1371/journal.pone.0180165

32. Aviram M, Vaya J. Paraoxonase 1 activities, regulation and interactions with atherosclerotic lesion. Curr Opin Lipidol. 2013;24(4):339-344. DOI: 10.1097/MOL.0b013e32835ffcfd

33. Bhattacharyya T, Nicholls SJ, Topol EJ, Zhang R, Yang X, Schmitt D, et al. Relationship of paraoxonase 1 (PON1) gene polymorphisms and functional activity with systemic oxidative stress and cardiovascular risk. J Am Med Assoc 2008;299:1265-76. DOI: 10.1001/jama.299.11.1265

34. Szpakowicz A, Pepinski W, Waszkiewicz E, Maciorkowska D, Skawronska M, Niemcunowicz-Janica A, et al. The influence of renal function on the association of rs854560 polymorphism of paraoxonase 1 gene with long-term prognosis in patients after myocardial infarction. Heart Vessels 2016;31(1):15-22. DOI: 10.1007/s00380-014-0574-8

35. Karakaya P, Ozdemir B, Mert M, Okuturlar Y. Relation of paraoxonase 1 activity with biochemical variable, brachial artery intima – media thickness in patients with diabetes with or without obesity. Obes Facts 2018;11(1):56-66. DOI: 10.1159/000486513

36. Wysocka A, Cybulski M, Berbec H, Wysokinski A, Stazka J, Zapolski T. Prognostic value of paraoxonase 1 in patients undergoing coronary artery bypass grafting surgery. Med Sci Monit 2014;20:594-600. DOI: 10.12659/MSM.890025

37. Riedel M, Lafitte M, Pucheu Y, Couffinhal T. Prognostic value of high sensibility C reactive protein after acute coronary syndrome. Arch Cardiovasc Dis Suppl. 2010;2(1):2. DOI: 10.1016/S1878-6480(10)70007-0

Revista Romana de Medicina de Laborator

Romanian Journal of Laboratory Medicine

Journal Information


IMPACT FACTOR 2017: 0.400
5-year IMPACT FACTOR: 0.320



CiteScore 2017: 0.31

SCImago Journal Rank (SJR) 2017: 0.144
Source Normalized Impact per Paper (SNIP) 2017: 0.195

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 46 46 19
PDF Downloads 39 39 16