الفهرس 
Introduction
Aim of the WorkOnly 14 pages are availabe for public view
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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.
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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,
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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.
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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
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future of cardiac biomarkers will follow the analysis of a
panel of markers for the diagnosis and prognosis of myocardial
infarction