ABC | Volume 113, Nº1, July 2019

Original Article Serum Sirtuin 1, 3 and 6 Levels in Acute Myocardial Infarction Patients Emrullah Kızıltunç, 1 A rzu Kösem, 2 Can Özkan, 1 Burcu Uğurlu Ilgın, 3 Harun Kundi, 1, 4 M ustafa Çetin, 1 Ender Ornek 1 TC Saglik Bakanligi Ankara Numune Egitim ve Arastirma Hastanesi - Cardiology, 1 Ankara – Turkey TC Saglik Bakanligi Ankara Numune Egitim ve Arastirma Hastanesi - Medical Biochemistry, 2 Ankara – Turkey TC Saglık Bakanlıgı Gazi Mustafa Kemal Devlet Hastanesi – Cardiology, 3 Ankara – Turkey Beth Israel Deaconess Medical Center – Cardiology, 4 Boston, Massachusetts – USA Mailing Address: Emrullah Kızıltunç • TC Saglik Bakanligi Ankara Numune Egitim ve Arastirma Hastanesi - Cardiology Talatpaşa Bulvarı, N° 44, Altındağ, Ankara 06100 – Turkey E-mail: e.kiziltunc@gmail.com Manuscript received August 21, 2018, revised manuscript October 25, 2018, accepted November 01, 2018 DOI: 10.5935/abc.20190114 Abstract Background: Sirtuins may act in many cellular processes like apoptosis, DNA repair and lipid/glucose metabolism. Experimental studies suggested some sirtuin types may have protective effects against endothelial dysfunction, atherosclerosis, cardiac hypertrophy and reperfusion injury. Data about sirtuins in acute myocardial infarction (AMI) patients are scarce. Objectives: To investigate temporal changes of serum sirtuin 1,3 and 6 levels in AMI patients; to compare the serum sirtuin 1,3 and 6 levels between AMI patients and control subjects; and to investigate the association of serum sirtuin 1,3 and 6 levels with prognostic markers of AMI. Methods: Forty patients with AMI and 40 patients with normal coronary arteries were included. Left ventricular ejection fraction (LVEF), serum proBNP, CRP, sirtuin1, sirtuin 3 and sirtuin 6 levels were processed. Peak troponin T levels, GRACE score, first day / second day sirtuin levels were recorded of AMI patients. A p value < 0.05 was considered statistically significant. Results: Serum sirtuin 1,3 and 6 levels in AMI patients were similar to those in normal coronary patients. No temporal change in serum sirtuin 1,3 and 6 levels were found in AMI course. No correlation was evident between the sirtuin levels and the following parameters: proBNP, CRP, peak troponin and LVEF. Baseline sirtuin 1 and 6 levels were positively correlated with reperfusion duration. Baseline sirtuin 3 levels were negatively correlated with GRACE score. Conclusion: Serum sirtuin 1,3 and 6 levels in AMI patients were similar to those in normal coronary patients. This study does not represent evidence of the possible protective effects of sirtuin1, 3 and 6 in AMI patients. (Arq Bras Cardiol. 2019; 113(1):33-39) Keywords: Sirtuins/drug effects; Atherosclerosis; Lipid Metabolism; Endothelium/dysfunction; Cardiomegaly; Cellular Senescence; Carcinogenesis Introduction Sirtuins are NAD (nicotinamide adenine dinucleotide) dependent enzymes which consist of seven members called Sirt 1-7. 1 The best known function of sirtuins is deacetylation, but they can also function as mono ADP ribosyltransferase, lipoamidase, demalonylase and desuccinylase. 2,3 Sirtuins are involved in several biological processes like apoptosis, cellular survival, DNA repair/cellular aging and lipid/glucose metabolism. 4 The information about the functions of sirtuins in carcinogenesis, aging and inflammation is also increasing. 4,5 Additionally, there exist evidences that circulating sirtuin levels may associate with frailty, reduction of body fat mass or diabetes mellitus. 6-8 Contemporary knowledge about the functions of sirtuins in the cardiovascular system in health and disease states is also evolving. Recent experimental studies have demonstrated the possible role of sirtuins in various cardiovascular pathologies like cardiac hypertrophy, heart failure, endothelial dysfunction and atherosclerosis. 9,10 Survival of the acute myocardial infarction (AMI) patients have significantly improved with the advanced catheter‑based therapies and increased availability of coronary care units, but this resulted increase in heart failure population. 11 Infarct size reduction is crucial to decrease the probability of clinical heart failure and to improve prognosis in AMI patients. Early reperfusion and reduction of reperfusion injury are basic management approaches to reduce the infarct size. However, there exist many variables ascertaining infarct size and only a little is known about the underlying sophisticated molecular mechanisms. Inflammation, thrombogenicity, and oxidative stress effect infarct size and prognosis. 12-14 Experimental studies revealed that sirtuin 1, 3 and 6 have beneficial effects against atherosclerosis, dyslipidemia, oxidative stress, endothelial dysfunction and inflammation. In addition, sirtuin 1 and 3 may activate cardioprotective pathways in the setting of AMI. 9 Therefore, serum sirtuin levels may associate with reduced myocardial infarct size and good prognostic markers in AMI patients. To the best of our knowledge, there is no data about the association between serum sirtuin 1,3 and 6 levels and prognostic markers of AMI patients in 33