Decreased plasma extracellular superoxide dismutase level in patients with vasospastic angina

Objective Extracellular superoxide dismutase (EC-SOD) is the major extracellular scavenger of superoxides, and one of the main regulators of nitric oxide bioactivity in vessel walls. Here, we examined whether plasma EC-SOD level was associated with vasospastic angina (VSA), and if it was a risk factor for VSA. Methods and results We assigned 105 patients with normal or mildly stenotic coronary arteries into either a VSA (n = 58) or chest pain syndrome (CPS) (n = 47) groups. Plasma EC-SOD and other biochemical variables were measured, and major coronary risk factors were assessed. Results showed that apart from smoking status there were no significant differences in patient characteristics and biochemical variables between the two groups. In the VSA group, prevalence of smoking was significantly higher (53% versus 26%, p = 0.0055), and plasma EC-SOD level was significantly lower (68.9 ± 18.5 ng/ml versus 83.8 ± 25.9 ng/ml; p = 0.0009). Not only smoking (OR 2.742, 95% CI 1.032–7.287, p = 0.0431) but also plasma EC-SOD (OR 0.971, 95% CI 0.949–0.993, p = 0.0102) was an independent risk factor for VSA. Conclusions In patients with VSA, plasma EC-SOD level was substantially reduced. Furthermore, plasma EC-SOD level followed by cigarette smoking was the most predictive risk factor for coronary spasms.