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Abstract CVD is the leading cause of death in the developed as well as in the developing world. The annual mortality of CVD is expected to reach 23.6 million by 2030. ACS describes the range of myocardial ischemic states that includes UA, NSTEMI, or STEMI. The diagnosis and classification of ACS is based on a thorough review of clinical features, including electrocardiogram (ECG) findings and biochemical markers of myocardial necrosis. The goal of reperfusion therapy with fibrinolytic drugs or pPCI is to restore blood flow to ischemic, but still viable, myocardium, and reduce infarct size. The myocardial tissue-specific biomarker cardiac troponin, high sensitivity assays for cardiac troponin, and cardiac enzymes all help diagnose myocardial infarction (MI) in the early hours following symptoms. Inflammatory markers such as PTX-3 and GAL-3 predict MI. Markers for plaque instability may be more useful for diagnosing ACS at the earliest stage; however sLOX-1 appears to play crucial roles in the pathogenesis of atherosclerotic plaque rupture and ACS onset. Summary 117 The present study aimed to evaluate a spectrum of novel biomarkers levels (PTX-3, GAL-3, and sLOX-1) in patients with AMI compared to controls and study their role in AMI. One hundred fifty patients with ST elevation myocardial infarction (STEMI) were included with 30 healthy subjects served as controls. Blood samples were drawn from all patients before primary percutaneous coronary intervention (PCI) and after 12 and 48 hours. Critical changes in cTnI as well as in PTX-3, GAL-3, sLOX- 1, lipid profile, CRP, RBS and cardiac enzymes markers were examined. The results of this study showed that; the mean level of laboratory investigations between patients group and control group regarding troponin I, LDH, CRP, CK-Total, CK-MB and AST, and the mean levels were significantly higher in patients group in all investigations. Our results revealed that there is a significant (P<0.05) increase in the serum troponin I (0.55±0.76) as compared to controls (0.02±0.01). Results of different laboratory investigations showed that a highly significantly (P<0.001) increase in LDH, AST, CK-total, CK-MB, CRP, RBS, Cholesterol, Triglyceride, HDL, LDL, Summary 118 and VLDL were observed among the acute STEMI patients as compared to controls. Also, a highly significant (P<0.001) increase was found in the serum PTX-3 (5.69±1.37), GAL-3 (13.39±1.80), and sLOX-1 (112.79±10.76) when compared to controls (2.68±0.61, 7.16±0.95 & 47.75±12.87; respectively). On comparing the mean levels of PTX-3, GAL-3, and sLOX-1 at zero time, after 12 hrs and 48 hrs, there was highly significant increase with p- value > 0.001. The correlation of PTX-3, GAL-3, and sLOX-1 with the different measured parameters, results revealed that there is a highly significant positive correlation between PTX-3 with Troponin I, AST, CK-total, CK-MB and CRP (p value > 0.001); while there is significant negative correlation between PTX-3 with Age, diastolic BP and RBS. While for GAL-3; it was found that it has a significant positive correlation with Troponin I, AST, CK-total, CK-MB and CRP, and significant negative correlation with RBS. While for sLOX-1 with the different measured parameters, our results revealed that there were significant positive correlations with sLOX-1 and Troponin I, CK-MB, CRP, Cholesterol, T.G, LDL and VLDL. Summary 119 In discrimination of myocardial infarction patients; results of the current study showed that AUC for troponin I is 0.922 (cut off value >0.03) with sensitivity of 96% and specificity of 85%, PTX- 3 is 0.892 (cut off value >3.9) with sensitivity of 90% and specificity of 85%, GAL-3 is 0.961 (cut off value >8.5) with sensitivity of 94% and specificity of 85%, and sLOX-1 is 0.857 (cut off value >71.3) with sensitivity of 93% and specificity of 85%. In conclusion over the last 50 years, the contribution of biomedical research to the management of cardiac diseases has become increasingly sophisticated. The analysis of cardiac biomarkers has become the frontline diagnostic tools for AMI, and has greatly enabled the clinicians in the rapid diagnosis and prompt treatment planning, thereby reducing the mortality rate to a great extent. There is now accumulating evidence that a multi-marker strategy, employing a patho-biologically diverse set of biomarkers, is likely to help significantly in the assessment of patients with cardiac disease. In particular, markers of plaque destabilization and/or markers of myocardial ischemia and inflammation could be added to the existing markers of cardiac necrosis and function in this paradigm if shown to contribute additional independent information. However, the Summary 120 future of cardiac biomarkers will follow the analysis of a panel of markers for the diagnosis and prognosis of myocardial infarction |