الفهرس 
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Abstract
Coronary artery disease (CAD) is the leading cause of cardiovascular death globally. Egypt has the largest population in middle east and north Africa with significant high CAD mortality rate.
The two major forms of coronary artery disease (CAD) are stable angina and acute coronary syndrome (ACS). The term ACS refers to a group of clinical symptoms caused by active myocardial ischaemia, which includes Unstable angina (UA) and acute myocardial infarction (AMI).
Unstable angina and acute myocardial infarction are currently assessed clinically through risk score algorithms, myocardial enzyme, angiography and electrocardiography. However, they all have different drawbacks. Yet, the need to find novel biomarkers with high accuracy is always present, to allow earlier diagnosis with decreased mortality and complications.
Certain patterns of miRNA expression play a prime role in myocardial infarction, in addition to the fact that many cardiac miRNAs are dysregulated in patients with ACS. Therefore, the present study was designed to evaluate the diagnostic performance of miR-183-5p and miRNA-208-b in acute coronary syndrome patients
The study was conducted on 100 participants who were divided to three groups:
(I) group I (control group): 25 healthy people with no heart problems.
(II) group II (UA): 23 patients with unstable angina.
(III) group III (AMI group): 52 acute myocardial infarction.
Informed consent including inclusion and exclusion criteria was taken and a complete history was obtained from all participants before enrollment in this study.
All participants were subjected to:
- Full history and clinical examination
- Determination of serum lipid profile
- Determination of troponin I and creatine kinase.
- Determination of miRNA-208-b and miR-183-5p expression levels
- The results of the study were summarized as follows:
1- There was no significant difference in age, sex, hypertension and diabetes state among the three groups, while unstable angina and AMI patients showed a significant difference in smoking state when compared to the control group
2- Unstable angina and AMI patients showed non-significant difference in levels of total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein-cholesterol. However,
levels of triglycerides was increased in unstable angina (UA) and AMI patients compared to normal controls (p<0.001).
3- Serum CK-MB, and troponin I were significantly elevated in unstable angina patients. In the same context, AMI patients exhibited a significant increase in levels of CK-MB, and troponin I when compared to unstable angina patients.
4- Mir-183-5p and miR-208-b were significantly upregulated in the serum of unstable angina in adults and AMI patients compared to normal controls. Whereas, there was no significant difference between unstable angina and AMI patients in miR-183-5p expression levels. But, miR-208-b was significantly overexpressed in AMI patients compared to unstable angina (UA) patients.
5- The ROC curves showed that troponin I had diagnostic value for AMI with 86% sensitivity and 77% specificity. Whereas, mir- 183-5p had the highest diagnostic value with a sensitivity and specificity of (92% and 73%). While, showed that miR-208-b had diagnostic value which is associated with a sensitivity of 96% and specificity of 60%.