Document Type : Original Article(s)

Authors

1 Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Infectious Diseases and Tropical Medicine Research Center AND Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

3 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, AND Students Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

4 Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Science, Isfahan, Iran

5 Assistant Professor, Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

BACKGROUND: Myocardial ischemia may recur in a significant subset of patients following percutaneous coronary intervention (PCI). Lycopene, a carotenoid with antioxidant activity, has evidence for beneficial effects on cardiovascular system. In the present study, we aimed to evaluate the possible preventive effect of lycopene against post-PCI myocardial damage by detection of cardiac biomarkers of ischemia.METHODS: A total of 45 patients who planned to undergo elective PCI were randomly assigned to two groups to receive either lycopene (30 mg 12 hours before PCI as well as 15 mg just before and 8 hours after PCI) along with standard treatment (n = 23) or only standard treatment (n = 22). Standard treatment included aspirin, a statin, and a beta-blocker. The serum levels of creatine kinase-MB (CK-MB), troponin I, and high sensitivity C-reactive protein (hs-CRP) were measured 12 hours before and 12 hours after the procedure and were compared between the two groups.RESULTS: The use of lycopene significantly prevented the increase of CK-MB following PCI compared to control (P = 0.048). However, it had not any significant effect on serum levels of troponin I (TnI) (P = 0.176) and hs-CRP (P = 0.186) compared to control.CONCLUSION: Lycopene can prevent the increase of CK-MB following PCI. Therefore, it has the potential for prevention of post-PCI cardiovascular events. However, more studies are needed to confirm such an effect.

Keywords

  1. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics-2016 update: A report from the American Heart Association. Circulation 2016; 133(4): e38-360.
  2. Castelli WP. The new pathophysiology of coronary artery disease. Am J Cardiol 1998; 82(10B): 60T-5T.
  3. Thom T, Haase N, Rosamond W, Howard VJ, Rumsfeld J, Manolio T, et al. Heart disease and stroke statistics-2006 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2006; 113(6): e85-151.
  4. Zimarino M, Affinito V. The prognosis of periprocedural myocardial infarction after percutaneous coronary interventions. Cardiovasc Revasc Med 2013; 14(1): 32-6.
  5. Yun KH, Jeong MH, Oh SK, Rhee SJ, Park EM, Lee EM, et al. Response of high-sensitivity C-reactive protein to percutaneous coronary intervention in patients with acute coronary syndrome. Heart Vessels 2009; 24(3): 175-80.
  6. Moon AR, Choi DH, Jahng SY, Kim BB, Seo HJ, Kim SH, et al. High-sensitivity C-reactive protein and mean platelet volume as predictive values after percutaneous coronary intervention for long-term clinical outcomes: A comparable and additive study. Blood Coagul Fibrinolysis 2016; 27(1): 70-6.
  7. Wada H, Dohi T, Miyauchi K, Shitara J, Endo H, Doi S, et al. Preprocedural high-sensitivity C-reactive protein predicts long-term outcome of percutaneous coronary intervention. Circ J 2016; 81(1): 90-5.
  8. Vieira de Melo RM, Hueb W, Nomura CH, Ribeiro da
  9. Silva EE, Villa AV, Oikawa FTC, et al. Biomarker release after percutaneous coronary intervention in patients without established myocardial infarction as assessed by cardiac magnetic resonance with late gadolinium enhancement. Catheter Cardiovasc Interv 2017; 90(1): 87-93.
  10. Cheng HM, Koutsidis G, Lodge JK, Ashor AW, Siervo M, Lara J. Lycopene and tomato and risk of cardiovascular diseases: A systematic review and meta-analysis of epidemiological evidence. Crit Rev Food Sci Nutr 2019; 59(1): 141-58.
  11. Sawardekar SB, Patel TC, Uchil D. Comparative evaluation of antiplatelet effect of lycopene with aspirin and the effect of their combination on platelet aggregation: An in vitro study. Indian J Pharmacol 2016; 48(1): 26-31.
  12. Hung CF, Huang TF, Chen BH, Shieh JM, Wu PH, Wu WB. Lycopene inhibits TNF-alpha-induced endothelial ICAM-1 expression and monocyte-endothelial adhesion. Eur J Pharmacol 2008;
  13. (1-3): 275-82.
  14. Zou J, Feng D, Ling WH, Duan RD. Lycopene suppresses proinflammatory response in lipopolysaccharide-stimulated macrophages by inhibiting ROS-induced trafficking of TLR4 to lipid raft-like domains. J Nutr Biochem 2013; 24(6): 1117-22.
  15. Petyaev IM. Lycopene deficiency in ageing and cardiovascular disease. Oxid Med Cell Longev 2016; 2016: 3218605.
  16. Soliman R, Zohry G. The myocardial protective effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery. Ann Card Anaesth 2016; 19(4): 606-13.
  17. Selvanayagam JB, Porto I, Channon K, Petersen SE, Francis JM, Neubauer S, et al. Troponin elevation after percutaneous coronary intervention directly represents the extent of irreversible myocardial injury: Insights from cardiovascular magnetic resonance imaging. Circulation 2005; 111(8): 1027-32.
  18. Brener SJ, Lytle BW, Schneider JP, Ellis SG, Topol EJ. Association between CK-MB elevation after percutaneous or surgical revascularization and three-year mortality. J Am Coll Cardiol 2002; 40(11): 1961-7.
  19. Smith SC Jr, Feldman TE, Hirshfeld JW Jr, Jacobs AK, Kern MJ, King SB 3rd, et al. ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update 2001 Guidelines for Percutaneous Coronary Intervention). Circulation 2006; 113(7): e166-e286.
  20. He Q, Zhou W, Xiong C, Tan G, Chen M. Lycopene attenuates inflammation and apoptosis in post-myocardial infarction remodeling by inhibiting the nuclear factor-kappaB signaling pathway. Mol Med Rep 2015; 11(1): 374-8.
  21. Wang X, Lv H, Gu Y, Wang X, Cao H, Tang Y,
  22. et al. Protective effect of lycopene on cardiac function and myocardial fibrosis after acute myocardial infarction in rats via the modulation of p38 and MMP-9. J Mol Histol 2014; 45(1): 113-20.
  23. Hu MY, Li YL, Jiang CH, Liu ZQ, Qu SL, Huang YM. Comparison of lycopene and fluvastatin effects on atherosclerosis induced by a high-fat diet in rabbits. Nutrition 2008; 24(10): 1030-8.
  24. Engelhard YN, Gazer B, Paran E. Natural antioxidants from tomato extract reduce blood pressure in patients with grade-1 hypertension: a double-blind, placebo-controlled pilot study. Am Heart J 2006; 151(1): 100.
  25. Rissanen TH, Voutilainen S, Nyyssonen K, Lakka TA, Sivenius J, Salonen R, et al. Low serum lycopene concentration is associated with an excess incidence of acute coronary events and stroke: the Kuopio Ischaemic Heart Disease Risk Factor Study. Br J Nutr 2001; 85(6): 749-54.
  26. Kohlmeier L, Kark JD, Gomez-Gracia E, Martin
  27. BC, Steck SE, Kardinaal AF, et al. Lycopene and myocardial infarction risk in the EURAMIC Study. Am J Epidemiol 1997; 146(8): 618-26.
  28. Biddle MJ, Lennie TA, Bricker GV, Kopec RE, Schwartz SJ, Moser DK. Lycopene dietary intervention: A pilot study in patients with heart failure. J Cardiovasc Nurs 2015; 30(3): 205-12.
  29. Jacob K, Periago MJ, Bohm V, Berruezo GR. Influence of lycopene and vitamin C from tomato juice on biomarkers of oxidative stress and inflammation. Br J Nutr 2008; 99(1): 137-46.
  30. Nozari Y, Eshraghi A, Talasaz AH, Bahremand M, Salamzadeh J, Salarifar M, et al. protection from reperfusion injury with intracoronary n-acetylcysteine in patients with stemi undergoing primary percutaneous coronary intervention in a cardiac tertiary center. Am J Cardiovasc Drugs 2018; 18(3): 213-21.
  31. Foroughinia F, Salamzadeh J, Namazi MH. Protection from procedural myocardial injury by omega-3 polyunsaturated fatty acids (PUFAs): Is related with lower levels of creatine kinase-MB (CK-MB) and troponin I? Cardiovasc Ther 2013; 31(5): 268-73.