High-sensitive cardiac troponin I (hs-cTnI) is a recognized marker of myocardial injury in acute coronary syndromes, but its utility in chronic coronary syndromes (CCS) remains unclear. Midkine (MK), a heparin-binding growth factor, plays a role in inflammation and vascular remodeling in atherosclerosis. This cross-sectional study aimed to evaluate the predictive value of serum hs-cTnI and MK in determining the severity of coronary artery obstruction in patients with CCS. The study included 125 subjects undergoing coronary angiography (CAG) at the Iraqi Center of Heart Disease/ Medical City/Baghdad, from March to December 2024. Subjects were classified into three groups based on CAG findings: no CAD, 1- or 2-vessel disease, and 3-vessel or left main disease. Serum levels of hs-cTnI and MK were measured using enzyme-linked immunosorbent assay (ELISA) in the laboratories of Department of Biochemistry/College of Medicine/ Baghdad University. Median serum levels of both biomarkers differed significantly across all groups. Receiver operating characteristic curve analysis demonstrated good diagnostic performance for both biomarkers in differentiating moderate (Group II) from severe disease (Group III). For hs-cTnI, a cutoff of 354.4 pg/mL yielded 90% sensitivity and 92% specificity; for MK, a cutoff of 2.75 ng/mL yielded 90% sensitivity and 85% specificity. Logistic regression revealed that the two biomarkers together explained 75% of the variance in CAD severity. Combining the two markers offered a slight improvement in diagnostic accuracy compared to using either alone. In conclusion, serum hs-cTnI and MK levels may help predict CAD severity in CCS and support early risk stratification before CAG.
Background: Coronary artery disease is a leading cause of death worldwide. Troponin is released into blood from patients with reversible myocardial ischemia. Stromelysin-2 is also involved in the development and progression of atherosclerosis by tissue remodeling and degradation of extracellular matrix proteins.Objectives: To investigate the role of serum high-sensitive cardiac troponin I (hs-cTn I) and Stromelysin-2 (Str-2) in the diagnosis and determination of the severity of coronary artery obstruction.Methods: This cross-sectional study was conducted on 125 subjects undergoing coronary angiography for suspicion of coronary artery disease in Baghdad Teaching Hospital/ Medical City complex/ Baghdad/ Iraq by the Department of Bioch
... Show MoreAims: The aim of this study was to evaluate the value and accuracy of longitudinal strain in detection of coronary artery disease compared to coronary angiography. Results: The left ventricular longitudinal strain-speckle tracking showed evidence of stenosis of left anterior descending artery, circumflex artery and right coronary artery in (86.1%), (76.4%), and (84.7%) respectively. For the stenosis in left anterior descending artery, the current study showed that the longitudinal strain was a good predictor for presence of significant stenosis with a sensitivity of (93.8%), specificity (75%) and accuracy (91.7%) compared with coronary angiography. For the stenosis in right coronary artery, the left ventricular longitudinal strain had
... Show MoreBackground: A noninvasive method of determining the severity of coronary artery disease (CAD) is the use of cardiac biomarkers. This study aimed to investigate the use of serum levels of high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) in determining CAD severity.Methods: This cross-sectional study included 125 participants categorized by coronary angiographic results into 3 groups: group I (no or < 50% stenosis), group II (1 or 2 vessels with ≥ 50% stenosis), and group III (left main stem or ≥ 3 vessels with ≥ 50% obstruction). Serum hs-cTnI and NT-proBNP levels were measured by enzyme-linked immunosorbent assay. Data were analyzed using SPSS version 25.0 and described as pe
... Show MoreAbstractBackground:Reduced glomeular filtration rate isassociated with increasedmorbidity in patientswith coronary arterydisease.Objectives :To analyze the declining eGFR andmortality risks in a patients with Chronic KidneyDisease and have had Coronary Artery Diseaseincluding risk factors .Patientsand Methods:The study included (160)patientsbetween the ages of 16 and 87years.Glomerular filtration rate was estimated (eGFR)using the Modification of Diet in Renal Diseaseequationand was categorized in the ranges<60 mL· min−1 per 1.73 m2and≥ 60 ml/min/1.73 m2.Baseline risk factors were analyzed by category ofeGFR,.The studied patients in emergencydepartment, were investigatedusing Coxproportional hazard models adjusting for traditiona
... Show MoreBackground: Coronary artery disease (CAD) is a major contributor to morbidity and mortality worldwide. Early-onset CAD, also known as PCAD, is a severe form of CAD associated with high mortality and a poor prognosis. Early diagnosis is crucial to reducing complications. While hsCRP is an established biomarker for CAD, kalirin is a potential novel biomarker due to its role in promoting smooth muscle proliferation and endothelial dysfunction. Objective: To evaluate the relationship between serum kalirin and hsCRP levels with the presence and severity of PCAD and to compare the diagnostic value of both biomarkers. Method: The study recruited 92 participants into two groups: the PCAD group (46) included patients with confirmed CAD by an
... Show MoreBackground: Coronary artery disease remains the main cause of death despite several preventive programs. Epicardial adipose tissue is a visceral fat depot of the heart located along the large coronary arteries and on the surface of ventricles and apex. Intima media thickness is commonly recognized as the initial stage in the development of atherosclerosis. The development of ultrasound machines, advances in echocardiographic devices and high resolution transducers facilitate comprehensive analysis of epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT).
Aim: To investigate the relationship of echocardiographic epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT) with the severity of coro
Back ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI
Background: Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial wall. SCAD is a highly uncommon cause of myocardial infarction (0.1 to 0.4 %).
Case presentation: 40-year-old African American woman, G1T1P0A0L2, with a past medical history of tobacco abuse and obesity who had uncomplicated cesarean section delivery for healthy twins two weeks prior presented with substernal, sudden onset chest pain. The pain radiated to left arm and back, pressure-like, and is associated with nausea, vomiting, and dyspnea.
On examination she was within normal limits except for a well-healed C-section wound. An electrocardiogr
... Show MoreBACKGROUND : Bifurcational coronary lesions are
frequent and amounts to almost one fifth of routine
practice concerning up to 15 – 20 % of cases .
Revascularization by percutaneous coronary
intervention ( PCI ), of bifurcational lesion has
become easier by stenting yet it remains a frequent
challenge.
OBJECTIVE : To evaluate the success and hospital
complications of two most frequent technique of stent
deployment in bifurcational PCI.
METHODS : We prospectively analysed the data of
140 consecutive patients with bifurcational PCI at
Ibn_Al-Bitar Hospital for cardiac surgery for the
period from July 2008 to July 2009 .
Depending on whether the side branch was stented or
not, the patient has fa
Objective: to assess the risk factors of coronary artery disease patients.
Methodology: A non-probability (purposive) sample of (100) patients. The study population consisted of
a sample of adults from both genders whose ages were 30 years and more, and was newly diagnosed as
having CAD by coronary angiography in the cardiac catheterization unit of An Nasiriyah heart center.
Results: The result of the study showed that the most common modifiable risk factors were low HDL-C
levels (58%), smoking (53%), hypertension (46%), diabetes mellitus (34%), obesity (30%), high
triglycerides (19%), hypercholesterolemia (17%), and high LDLC (14%). All these factors were positively
and significantly associated with the development