H-FABP, PCT, Lp-PLA2, and inflammatory cytokines emerge as valuable diagnostic tools for ischemic heart disease

Ischemic heart disease (IHD) remains a leading cause of global mortality and morbidity, stemming from inadequate blood supply to the heart. Accurate and early diagnosis is crucial for effective management and improved patient outcomes. Traditional biomarkers like troponin I, while important, may not fully capture the complex pathophysiology, particularly the inflammatory component. There is a critical need for novel biomarkers that can enhance diagnostic precision, differentiate between stable and acute presentations, and potentially identify new therapeutic targets beyond current standard-of-care approaches.

This observational study, conducted at Nasiriyah Heart Hospital, Iraq, from October 2021 to October 2022, investigated novel biomarkers in 86 stable angina patients, 50 acute myocardial infarction (MI) patients, and healthy controls. Researchers measured serum levels of traditional markers like troponin I, CK-MB, and myoglobin, alongside new biomarkers including hs-CRP, H-FABP, Lp-PLA2, PCT, and inflammatory cytokines TNF-α, IL-1β, IL-6, and IL-9. All biomarker levels were quantified using ELISA and other immunoassay techniques.

In patients with stable angina, serum troponin I levels did not significantly change compared to healthy controls. However, a significant increase was observed in serum levels of CK-MB, myoglobin, hs-CRP, H-FABP, Lp-PLA2, and PCT. Furthermore, inflammatory cytokines IL-6, IL-1β, IL-9, and TNF-α were also significantly elevated in stable angina patients. Similarly, in the acute MI group, serum troponin I levels were insignificantly changed compared to controls. Yet, a significant increase was recorded for myoglobin, CK-MB, hs-CRP, Lp-PLA2, PCT, and H-FABP. Inflammatory cytokines TNF-α, IL-9, IL-6, and IL-1β were also significantly elevated in acute MI patients. These findings highlight the consistent elevation of novel inflammatory and cardiac stress markers across both IHD presentations. > In both stable angina and acute MI patients, novel biomarkers including H-FABP, PCT, Lp-PLA2, and inflammatory cytokines TNF-α, IL-1β, IL-6, and IL-9 were significantly elevated compared to healthy controls, suggesting their utility beyond traditional markers.