Relationship of Autophagy and Apoptosis with Total Occlusion of Coronary Arteries
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Background: The primary aim of this study was to evaluate the level of autophagy and apoptosis enzymes in patients with coronary artery disease (CAD). Furthermore, we investigated the role of autophagy and apoptosis in the progression of coronary collateral and coronary total occlusion (TO). Material/Methods: We enrolled 115 patients in this prospective, observational, controlled study, who were categorized into 3 groups as follows: group 1, patients with chronic TO (n=49); group 2, patients with acute TO such as myocardial infarction (n=36); and group 3, healthy control patients (n=30). We used the enzyme-linked immunosorbent as-say (ELISA) kit for autophagy-related protein 5 (ATG5) and apoptosis (M30) in the plasma for these 3 groups. Results: Autophagy levels significantly varied among the groups (13.7 +/- 5.3 ng/mL, 11.7 +/- 3.4 ng/mL, and 7.5 +/- 3, respectively; P<0.001). In addition, apoptosis levels significantly varied among the groups (78.6 +/- 33.4 ng/mL, 64.9 +/- 30.6 ng/mL, and 47.6 +/- 18.2, respectively; P<0.001). The subgroup analysis revealed significant positive correlations between the autophagy level and the Rentrop score in contrast to apoptosis in group 1 (r=0.463; P<0.001). Conclusions: This study determined that autophagy and apoptosis levels were higher in patients with CAD than in healthy controls. In contrast to the serum apoptosis level, serum autophagy levels demonstrated a significant positive correlation with the Rentrop score. Hence, an elevated autophagy level might be a potential activator and marker of the process by which the body protects itself in CAD.