Objective. We sought to investigate whether a brief episode of myocardial ischemia produces a detectable cardiac oxidative stress in patients undergoing elective coronary angioplasty (PTCA). Background. Although cardiac oxidative stress has been dearly demonstrated in experimental models of ischemia-reperfusion, its presence in patients after transient myocardial ischemia is still unclear. Methods. In order to evaluate oxidative stress in ischemic cardiac regions, plasma conjugated dienes (CD), lipid hydroperoxides (ROOHs) and total antioxidant capacity (TRAP), independent indexes of oxidative stress, were measured in the aorta and great cardiac vein (GCV) before (t(0)), 1, (t(1)), 5 (t(5)) and 15 min (t(15)) after first balloon inflation in 15 patients undergoing PTCA on left anterior descending coronary artery (Group 1); six patients with right coronary artery stenosis (Group 2), which is not drained by the GCV, were studied as controls. Results. In Group 1 at baseline, CD and ROOHs levels were higher in GCV than in aorta (p < 0.01 for both), and TRAP levels were lower (p < 0.01). Aortic levels of CD, ROOHs and TRAP did not change at any time after t(0); venous levels of CD and ROOHs levels markedly increased at t(1), at t(5) and remained elevated ar t(15) (P < 0.01 for all comparisons vs. t(0)); venous levels of TRAP decreased at t(1) and t(5) (p < 0.01 vs. t(0)) and returned to normal at t(15). In Group 2, CD, ROOHs and TRAP levels were similar in the aorta and GCV and did not change throughout the study. Conclusions. Short episodes of myocardial ischemia duringPTCA induce a sustained oxidative stress, which is detectable in the venous eifluent oireperfused myocardium. (C) 2000 by the American College of Cardiology.