Cezar-Dumitrel Luca ALEXANDRA BOIERIU Daniela Neculoiu Diana Tint ^*

• Transilvania University of Brașov, Brasov, Romania

Background: Coronary artery bypass grafting (CABG) is frequently used to treat severe coronary artery disease (CAD), but it can lead to increased oxidative stress and inflammation, worsening patient outcomes. Remote ischemic preconditioning (RIPC) has been suggested as a potential strategy to protect against these effects by modulating oxidative stress and inflammatory responses, though its impact on specific biomarkers requires further investigation. This study aims to assess the effects of remote ischemic preconditioning on inflammation markers and oxidative stress in patients with severe CAD undergoing coronary artery bypass grafting.We conducted a case-control study involving 80 patients with severe coronary artery disease (CAD) scheduled for coronary artery bypass grafting (CABG). Fifty percent of these patients received ischemic preconditioning prior to surgery. Plasma levels of Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) and Superoxide dismutase-1 (SOD-1) levels were measured in all individuals using the ELISA method at three important time points: before surgery (visit 1 or V1), immediately post-operatively (visit 2 or V2), and one week post-operatively (visit 3 or V3).We enrolled 80 patients, of which 40 were assigned to the studied group receiving remote ischemic preconditioning (RIPC) and 40 to the control group. There were no statistically significant differences between the groups regarding baseline, clinical, or operative characteristics. RIPC treatment significantly reduced plasma levels of Lectin-like oxidized low-density lipoprotein (LDL) receptor-1 (LOX-1) (p<0.05) as well as significantly increasing total values of Superoxide dismutase-1 (SOD-1) (p<0.05, respectively). There were notable differences between the studied and control groups at V2 and V3. The studied group had higher SOD-1 levels (p<0.05) and significantly lower LOX-1 levels at both time points (p < 0.05).The significant changes in plasma levels of both LOX-1 and SOD-1 observed in this study strongly suggest that remote ischemic preconditioning (RIPC) plays an important role in reducing oxidative stress and enhancing the antioxidative status of patients. This is evidenced by the marked decrease in LOX-1 levels, alongside a corresponding increase in SOD-1 levels, indicating that RIPC may contribute to improved cardioprotection through these mechanisms.