A Genetic and Biochemical Perspective: Acute Coronary Syndrome and Raftlin

Background: Inflammation plays a central role in the pathophysiology of acute coronary syndrome (ACS). Raftlin, a lipid raft-associated inflammatory protein involved in immune signaling, has emerged as a potential biomarker in cardiovascular disease. This study aimed to evaluate circulating raftlin levels and RFTN1 rs690037 polymorphism in patients with ACS. Methods: This prospective observational study included 100 participants comprising 50 patients diagnosed with ACS and 50 control subjects with angiographically normal coronary arteries. Serum raftlin concentrations were measured using enzyme-linked immunosorbent assay, and RFTN1 rs690037 polymorphisms were analyzed by real-time polymerase chain reaction. Correlation, receiver operating characteristic (ROC), multivariable logistic regression, and net reclassification improvement (NRI) analyses were performed. Results: Serum raftlin levels were significantly higher in the ACS group compared with controls (4.28 [3.48–5.78] vs. 3.38 [2.66–4.23] ng/dL, p = 0.003). Raftlin levels demonstrated significant positive correlations with LDL cholesterol and HbA1c levels in ACS patients (p < 0.05 for both). ROC analysis showed that raftlin had moderate discriminative ability for ACS detection (AUC: 0.672, 95% CI: 0.570–0.762, p = 0.002). Although raftlin was not independently associated with ACS after multivariable adjustment, incorporation of raftlin into the baseline clinical model improved overall risk classification (NRI: 0.213, p = 0.041). No significant association was observed between RFTN1 rs690037 polymorphism and ACS or circulating raftlin levels. Conclusions: Circulating raftlin levels are elevated in patients with ACS and appear to reflect the inflammatory and metabolic dysregulation accompanying acute coronary events. Although raftlin alone demonstrated limited diagnostic performance, its incremental contribution to multimarker risk assessment models suggests potential utility as a complementary inflammatory biomarker in ACS. Larger multicenter studies are warranted to clarify its prognostic and translational significance.