Assessment of Oxidative Stress, Cardiac Biomarkers, and Platelet Indices in Acute Myocardial Infarction: A Case-Control Study

Subject Areas : Journal of Chemical Health Risks

Ali Mohammed Brakat ^{1 *} , Hassan Sarhan Sachit ² , Ghassan Jabbar Auda ³ , Adnan Taan Thamer ⁴ , Raed Fanoukh Aboqader Al-Aouadi ⁵

1 - Consultant Microbiologist, Department of Microbiology and Immunology, College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
2 - Lecturer of Microbiology and Immunology Department of Microbiology and Immunology, College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
3 - Professor Dr. of Internal Medicine and intervention Cardiology, Director of Al-Rabea Cardiac Center, Dean of College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
4 - Professor Dr. of Internal Medicine, College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
5 - College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq

Received: 2025-02-17 Accepted : 2025-04-13 Published : 2025-06-15

Keywords: Acute Myocardial Infarction, Oxidative Stress, Cardiac Biomarkers, CK-MB, hs-CRP, Platelet Indices, Malondialdehyde (MDA),

Abstract :

Acute myocardial infarction (AMI) is a pathological condition primarily affecting the coronary arteries. The future risk of cardiac events is closely linked to abnormalities in heart biomarkers. The generation of free radicals due to oxidative stress leads to the oxidation of low-density lipoprotein (LDL), which subsequently contributes to the formation of atherosclerosis. In cases where necrosis occurs as a result of coronary artery occlusion, there is a notable increase in CK-MB levels. This study aimed to evaluate the levels of CK-MB, high-sensitivity C-reactive protein (hs-CRP), platelet indices, and malondialdehyde (MDA) in patients with acute myocardial infarction. A total of 19 patients with AMI who consulted outpatient clinics and were referred to the Al-Rabea Cardiac Center for further management were included in the study, along with 19 healthy controls. Blood samples (5 ml) were collected from each participant through venipuncture. After centrifugation, serum was separated and analyzed for lipid parameters (triglycerides, total cholesterol, LDL, high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL)), cardiac biomarkers (hs-CRP and CK-MB), and oxidative stress markers (malondialdehyde, MDA). The results indicated a significant increase in MDA, heart biomarkers, and lipid parameters in the AMI group compared to the control group, with the exception of HDL, which was found to be significantly decreased. Lipid peroxidation, as indicated by elevated MDA levels, was found to be closely associated with AMI. Furthermore, CK-MB, hs-CRP, and platelet parameters (PDW, platelet count, and MPV) could serve as valuable biomarkers for the diagnosis and understanding of the pathogenesis of AMI.

References:

1. Rehman S., Rehman E., Ikram M., Jianglin Z., 2021. Cardiovascular disease (CVD): assessment, prediction and policy implications. BMC Public Health. 21, 1-14.
2. Reed G.W., Rossi J.E., Cannon C.P., 2017. Acute myocardial infarction. The Lancet. 389(10065), 197-210.
3. Baidildinova G., Nagy M., Jurk K., Wild P.S., Ten Cate H., Van der Meijden P.E., 2021. Soluble platelet release factors as biomarkers for cardiovascular disease. Front Cardiovasc Med. 8, 684920.
4. Dubois-Deruy E., Peugnet V., Turkieh A., Pinet F., 2020. Oxidative stress in cardiovascular diseases. Antioxidants. 9(9), 864.
5. Heistad D.D., Wakisaka Y., Miller J., Chu Y., Pena-Silva R., 2009. Novel aspects of oxidative stress in cardiovascular diseases. Circ J. 73(2), 201-207.
6. Hamilton C.A., Miller W.H., Al-Benna S., Brosnan J., Drummond R.D., McBride M.W., Dominiczak A.F., 2004. Strategies to reduce oxidative stress in cardiovascular disease. Clin Sci. 106(3), 219-234.
7. Pignatelli P., Menichelli D., Pastori D., Violi F., 2018. Oxidative stress and cardiovascular disease: new insights. Kardiol Pol. 76(4), 713-722.
8. Mythili S., Malathi N., 2015. Diagnostic markers of acute myocardial infarction. Biomed Rep. 3(6), 743-748.
7. Gianazza E., Brioschi M., Martinez Fernandez A., Casalnuovo F., Altomare A., Aldini G., Banfi C., 2021. Lipid peroxidation in atherosclerotic cardiovascular diseases. Antioxid Redox Signal. 34(1), 49-98.
8. Korniluk A., Koper-Lenkiewicz O.M., Kamińska J., Kemona H., Dymicka-Piekarska V., 2019. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm. 2019(1), 9213074.
9. Zheng Y.Y., Wang L., Shi Q., 2022. Mean platelet volume (MPV) and platelet distribution width (PDW) predict clinical outcome of acute ischemic stroke: A systematic review and meta-analysis. J Clin Neurosci. 101, 221-227.
10. Trip M.D., Cats V.K., Van Capelle F.J.L., 1990. Platelet hyperreactivity and prognosis in survivors of myocardial infarction. N Engl J Med. 322, 1549-1554.
11. Senaran H., Ileri M., Altinbas A., Veeriken J., 2001. Thrombopoietin and mean platelet volume in coronary artery disease. Clin Cardiol. 24, 405-408.
12. Darzi M.M., Neamati N., Sadeghi F., Bijani A., Moudi E., 2024. An Intricate Relationship Between miR-155-5p Expression and Oxidative Stress in Bladder Cancer Patients Treated with Calmette-Guerin Immunotherapy. Int J Mol Cell Med. 13(2), 186-197.
13. Farhadi M., Mortazavi P., Motesaddi Zarandi S., Eidi A., 2023. Effects of the air pollution on the decreased P53, Nrf2 and HO-1 protein levels along with tissue damage caused by oxidative stress in the lung of rat as an animal model. Caspian J Environ Sci. 1-8. doi: 10.22124/cjes.2023.6825.
14. Sattarahmady N., Heli H., Mehdizadeh A.R., Yarmohammadi H., Mortazavi S.M.J., 2015. Evaluation of Serum Catalase Activity and Malondialdehyde Level as Stress Oxidative Biomarkers among Iranian Welders. Galen Med J. 4(3), e326. https://doi.org/10.31661/gmj.v4i3.326.
15. Ebrahimi Y., AL-Baghdady H.F.A., Hameed N.M., Iswanto A.H., Shnain Ali M., Hammoodi H.A., Hashim Kzar H., Aravindhan S., Khodaei S.M., Alikord M., Pirhadi M., 2022. Common fatty acids and polyphenols in olive oil and its benefits to heart and human health. Caspian J Environ Sci. 1-7. doi: 10.22124/cjes.2022.5976.
16. Thongrung R., Lapmanee S., Thongnuanjan Bray P., Suthamwong P., Deandee S., Pangjit K., Yuajit C., 2025. Gambogic Acid Mitigates Nephropathy by Inhibiting Oxidative Stress and Inflammation in Diabetic Rats. Int J Mol Cell Med. 14(1), 448-461.
17. Kardeh B., Kardeh S., Moein S.A., Namazi M.R., 2019. Evidence for the Important Role of Oxidative Stress in the Pathogenesis of Acne. Galen Med J. 8, e1291. https://doi.org/10.31661/gmj.v8i.1291.
18. Shahzamani S., Hosseini S.F., Karimi M., Khajoei Nejad F., Ghobadi R., Mazaheri Y., Parsaei P., 2023. Anticancer potential of Rhus coriaria L. (Sumac): A mini review. Caspian J Environ Sci. 1-5. doi: 10.22124/cjes.2023.6701.
19. Belhachem A.A., Amiar A., Boudia F., Yousfi M.J., Toumi H., 2024. Comprehensive case analysis of prostatic stones: The role of FTIR spectroscopy in biochemical and chemical characterization and management. J Biochem Phytomed. 3(2), 4-8. doi: 10.34172/jbp.2024.14.
20. Etemadi N., Abtahi Froushani S.M., Zangeneh A., Zangeneh M.M., Pirnejad-Talatapeh A., Abangah G., Kaki Sahne S., Ehteshamfar S., 2025. The effect of silver nanoparticles of aqueous extract of Artemisia dracunculus on the prevention of gastric ulcer induced by ethanol in rats. Plant Biotechnol Persa. 7(2), 1.