Association Between Oxidative Stress Biomarkers And Cardiac Injury Markers In Patients With Acute Myocardial Infarction: A Prospective Observational Study

Abstract

Background: Acute myocardial infarction (AMI) is a major cause of morbidity and mortality worldwide. In addition to myocardial injury, oxidative stress plays an important role in the development and progression of AMI. Cardiac biomarkers such as Troponin-T and CK-MB are widely used for diagnosing myocardial injury, whereas malondialdehyde (MDA) and superoxide dismutase (SOD) reflect oxidative stress and antioxidant defense. However, the relationship between cardiac injury biomarkers and oxidative stress markers during the early phase of AMI remains unclear. Objective: To evaluate the relationship between oxidative stress biomarkers (MDA and SOD) and cardiac injury markers (Troponin-T and CK-MB) at the time of admission (At 0 hour) and At 12 hours after admission in patients with acute myocardial infarction.

Materials and Methods: This prospective observational study included 110 patients with confirmed acute myocardial infarction admitted to the Departments of Cardiology and Emergency Medicine at MGM Medical College and Hospital, Navi Mumbai, between August 2024 and April 2026. Blood samples were collected at the time of admission (At 0 hour) and again at 12 hours after admission. Troponin-T was measured by electrochemiluminescence immunoassay, CK-MB by the enzymatic kinetic method, MDA by the Kei Satoh method, and SOD activity by the Marklund and Marklund method. Changes in biomarker levels over time were analyzed using the paired Student's t-test, while Pearson's correlation analysis was performed to determine the relationship between oxidative stress and cardiac biomarkers. A p-value of <0.05 was considered statistically significant.

Results: Troponin-T and CK-MB levels increased significantly from at the time of admission to 12 hours after admission (p < 0.0001), indicating ongoing myocardial injury. In contrast, MDA levels decreased significantly, while SOD activity increased significantly over the same period (p < 0.0001), suggesting improvement in oxidative stress following treatment. Pearson correlation analysis showed no significant relationship between oxidative stress markers and cardiac biomarkers at either at the time of admission or at 12 hours after admission.

Conclusion: Acute myocardial infarction is associated with significant changes in both cardiac injury biomarkers and oxidative stress biomarkers during the first 12 hours after admission. However, the absence of significant correlations between these biomarkers suggests that oxidative stress and myocardial injury represent independent pathophysiological processes during the early phase of AMI. Assessing both cardiac and oxidative stress biomarkers may therefore provide complementary information for understanding disease progression and patient management.