الفهرس 
Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Acute myocardial infarction is fatal event associated with 15% mortality
rate. Type 1 myocardial infarction is caused by coronary atherosclerotic plaque
rupture that promotes platelet activation& aggregation then activation of the
coagulation cascade that ends into thrombus formation. However not every
plaque rupture or fissuring results in thrombus formation. Hence we believe that
platelets play an important role in thrombus formation.
Platelets are corner stones of homeostasis occurring after plaque rupture.
Platelets are a-nuclear cells formed from the cytoplasm of megakaryocytes
(MKs) and circulate in the blood stream for about 7–10 days. Despite the
absence of a nucleus, platelets contain RNAs, including messenger RNA
(mRNA), long non-coding RNA and micro-RNA , accounting for more than
9,000 transcripts in healthy human donors.
A previous study showed that a gene-by-gene analysis of the platelet gene
expression identified five differentially expressed genes: (FKBP5, S100P,
SAMSN1, CLEC4E and S100A12) at the time of acute myocardial infarction
and the gene that show the most expression was FKBP5 gene, so we use FKBP5
gene to show it’s expression in ACS and relation to atherosclerotic plaque
rupture and thrombus formation.
Our study was a single centre, prospective study conducted at Nasr city
insurance hospital within the period from April 2022 to April 2023. The study
include 90 patient divided into two main groups healthy donors (30) and acute
coronary syndrome group (60) that subdivided into two more groups STEMI
group (30) and UA group (30). Data was collected including baseline co
morbidities and risk factors ( DM, HTN , Smoker , Dyslepidimia , CKD, IHD ) ,
before pelavix loading dose , 50cm blood samples were collected and
centrifuged to get ” PRP ” , ACS group underwent PCI at Nasr city cath lab unite,” UA ”group underwent IVUS to exclude presence of thrombus , gene kits
brought from Germany , PCR was done at Menofia University central lab.
FKBP5 gene expression, was statically high significant in (ACS group) in
comparison to (HD group), with ( P=.000 ), ROC curve shows that the FKBP5
gene expression can predict patients with acute coronary syndrome at the cut off
point > 3.04 with sensitivity of 70.0%, specificity of 90.0% and area under
curve (AUC) of 0.800. Hence our study concluded that we can depend on
FKBP5 gene as strong independent predictor for acute coronary syndrome
including STEMI and UA patients with cut off point > 3.04.
There was high statically significant increase in FKBP5 gene expression in
STEMI patients group in comparison to UA group and HD with
P-value ( < .001 ).We demonstrate that FKBP5 gene not only a predictor for
STEMI but have causative role in thrombus formation as D. Eicher J., et al
demonstrated its effect on platelet function.
So our study concluded that FKBP5 gene can be used as a predictor for
ACS, especially STEMI patients, and also has a role in thrombus formation,
future prospective studies to insure the thesis and know the mechanism of action
and know the effect of gene inhibition on ACS events.