Key result
Elevated serum ACE activity is linked to ~4-fold higher odds of acute myocardial infarction.
Why the study?
The study aimed to evaluate correlations between peak troponin-I, oxidative stress biomarkers, HbA1c, and serum ACE activity, and their impact on rate pressure product in AMI.
Are oxidative stress biomarkers (MDA, CD, GPx), HbA1c, peak troponin-I, and serum ACE activity correlated with blood pressure/rate pressure product and predictive of acute myocardial infarction?
Case-Control (n=716)
No
Are oxidative stress biomarkers (MDA, CD, GPx), HbA1c, peak troponin-I, and serum ACE activity correlated with blood pressure/rate pressure product and predictive of acute myocardial infarction?
Elevated HbA1c, serum ACE activity, and oxidative stress markers (MDA, CD) alongside reduced GPx activity correlate strongly with peak troponin-I and rate pressure product, serving as independent predictors of acute myocardial infarction.
Answers are grounded in this paper and cite their sources.
Elevated ACE activity may aid AMI prediction in case-control data; leaves open prospective validation beyond troponin and HbA1c.
The aim was to investigate this relationship by calculating 1) the correlation between peak troponin-C (peak-cTnI), levels of oxidative stress biomarkers, including lipid peroxidation products (malondialdehyde (MDA), conjugated dienes (CD)), and antioxidant enzyme activity (glutathione peroxidase (GPx)), and HbA1c and 2) the correlation between HbA1c and serum angiotensin-converting enzyme (ACE) activity, and its impact on the rate pressure product (RPP) in acute myocardial infarction (AMI). A case-control study was performed in 306 AMI patients having undergone coronary angiography and on 410 controls. GPx activity was reduced in association with increased MDA and CD in patients. Peak-cTnI was positively correlated with HbA1c, MDA, and CD levels. Serum ACE activity was negatively correlated with GPx. HbA1c was positively correlated with ACE activity and RPP. Linear regression analysis showed that peak-cTnI, ACE activity and HbA1c are significant predictors of AMI. Elevated HbA1c and peak-cTnI levels are associated with RPP elevation causing AMI. In conclusions, patients with elevated HbA1c, elevated ACE activity and cTnI are at increased risk of AMI with increasing RPP. Patients at risk of AMI can be identified at an early stage if the biomarkers HbA1c, ACE activity, and cTnI are measured and preventive measures are taken in a targeted manner.
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Mehri et al. (2023) conducted a case-control in Acute myocardial infarction (NSTEMI) (n=716). Serum ACE activity, peak troponin-I, HbA1c, and oxidative stress biomarkers (MDA, CD, GPx) vs. Healthy controls matched for age, sex, and geographic origin was evaluated on Acute myocardial infarction (AMI) risk prediction via multiple regression analysis of serum ACE activity (OR 4.04, 95% CI 4.00-10.25, p=0.024). Elevated serum ACE activity was the strongest independent predictor of acute myocardial infarction, alongside peak-cTnI and HbA1c.
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