Novel Correlation among C3, h-CRP, and WBC in the Pathogenesis of ST-elevation Myocardial Infarction
Subject Areas : Journal of Chemical Health RisksHassan Sarhan Sachit 1 , Ali Mohammed Brakat 2 , Gassan Jabbar Auda 3 , Raed Fanoukh Aboqader 4 * , Adnan Taan Thamer 5
1 - College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
2 - College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
3 - College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
4 - Al-Aouadi College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
5 - College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
Keywords: C3, hs-CRP, WBC, LDL, STEMI,
Abstract :
ST-segment elevation myocardial infarction (STEMI) is a major contributor to global morbidity and mortality, necessitating a deeper understanding of its pathophysiology. This study aimed to evaluate the correlation between white blood cell (WBC) counts, complement component C3, high-sensitivity C-reactive protein (hs-CRP), and high- and low-density lipoprotein levels in patients diagnosed with ST-segment elevation myocardial infarction (STEMI) compared to a healthy control group. A total of 60 participants were included, comprising 30 individuals diagnosed with STEMI and 30 healthy controls, who were recruited from outpatient clinics in Nassiyria Province, Iraq, between January and December 2024. Blood samples were collected and analyzed for WBC counts, hs-CRP, C3, and LDL levels using standardized laboratory techniques, including ELISA and spectrophotometry. The results showed a significant increase in hs-CRP (P<0.0001), WBC (P<0.0001), and LDL (P<0.0001) levels in the STEMI group compared to the control group, accompanied by a notable decrease in C3 levels (P<0.0001). A positive correlation was notably observed between BMI and increased levels of LDL (r = 0.939, P < 0.01). Additionally, a positive correlation was remarkably observed between BMI and increased levels of WBC (r= 0.815; P<0.01) and h-CRP (r= 0.805; P<0.01), but a negative correlation was detected between BMI and levels of HDL (r= - 0.0.937; P<0.01) and C3 (r= -0.733; P<0.01) These findings suggest that elevated inflammatory markers and lipid profiles may play a crucial role in the immunopathogenesis of STEMI. The study highlights the importance of monitoring these biomarkers in clinical settings, as they may provide insights into the inflammatory processes associated with myocardial infarction. Furthermore, the correlation among these markers could inform potential therapeutic strategies to mitigate inflammation and improve patient outcomes post-STEMI. Overall, this research contributes to the understanding of the complex interplay between lipid metabolism and inflammatory responses in the context of acute myocardial infarction, emphasizing the need for further investigation into targeted interventions for high-risk populations.
1. Reed G.W., Rossi J.E. and Cannon C.P., 2017. Acute myocardial infarction. The Lancet. 389(10065), 197-210.
2. Thygesen K., Alpert J.S., White H.D., Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction, 2007. Universal definition of myocardial infarction. Journal of the American College of Cardiology. 50(22), 2173-2195.
3. Lucaci L., 2022. ST segment elevation. Romanian Journal of Cardiology. 32(2). https://doi.org/10.2478/rjc-2022-0014.
4. Akbar H. Mountfort S., 2024. Acute ST-segment elevation myocardial infarction (STEMI). StatPearls. PMID: 30335314
5. Katoh O., Gotoh K., Tateyama H., Suzuki K., Yasumura Y., Ohnishi S., Fujii K., Hamano Y., Fukui S., Minamino T.,1986. Pathogenesis of Impending Myocardial Infarction and Acute Myocardial Infarction: Clinical and Angiographic Evaluation of Coronary Thrombosis as a Precipitating Factor: Symposium on pathogenesis of myocardial infraction: 49th Annual Scientific Session of Japanese Circulation Society. Japanese Circulation Journal. 50(2), 188-197.
6. Jovin D.G., Sumpio B.E., Greif D.M., 2024. Manifestations of human atherosclerosis across vascular beds. JVS-vascular Insights. 2, 100089.
7. Moussa S., Ambrose J.A., 2018. Understanding myocardial infarction. F1000Research, 7.
8. Gomes D.A., Paiva M.S., Freitas P., Albuquerque F., Lima M.R., Santos R.R., Presume J., Trabulo M., Aguiar C., Ferreira J. Ferreira A.M., 2024. Attainment of LDL-Cholesterol Goals in Patients with Previous Myocardial Infarction: A Real-World Cross-Sectional Analysis. Arquivos Brasileiros de Cardiologia. 121, e20230242.
9. Falih I.Q., Alobeady M.A., Banoon S.R., Saleh M.Y., 2021. Role of Oxidized Low-density Lipoprotein in Human Diseases: A Review. Journal of Chemical Health Risks. 11. DOI:10.22034/jchr.2021.684227
10. Bohula E.A., Giugliano R.P., Leiter L.A., Verma S., Park J.G., Sever P.S., Lira Pineda A., Honarpour N., Wang H., Murphy S.A., Keech A., 2018. Inflammatory and cholesterol risk in the fourier trial. Circulation, 138(2), 131-140.
11. Mortensen M.B., Nordestgaard B.G., 2020. Elevated LDL cholesterol and increased risk of myocardial infarction and atherosclerotic cardiovascular disease in individuals aged 70–100 years: a contemporary primary prevention cohort. The Lancet. 396(10263), 1644-1652.
12. Alloubani A., Nimer R., Samara R., 2021. Relationship between hyperlipidemia, cardiovascular disease and stroke: a systematic review. Current Cardiology Reviews. 17(6), 52-66.
13. Fang Z., Li, X., Liu J., Lee H., Salciccioli L., Lazar J., Zhang M., 2023. The role of complement C3 in the outcome of regional myocardial infarction. Biochemistry and Biophysics Reports. 33, 101434.
14. Moldovan R., Ichim V.A., Beliș V., 2023. Recent perspectives on the early expression immunohistochemical markers in post-mortem recognition of myocardial infarction. Legal Medicine. 64, 102293.
15. Wysoczynski M., Solanki M., Borkowska S., Van Hoose P., Brittian K.R., Prabhu S.D., Ratajczak M.Z., Rokosh G., 2014. Complement component 3 is necessary to preserve myocardium and myocardial function in chronic myocardial infarction. Stem Cells. 32(9), 2502-2515.
16. Fang Z., Lee H., Liu J., Wong K.A., Brown L.M. and Zhang M., 2023. Complement C3 interacts with cytochrome c to influence myocardial apoptosis during heart ischemia/reperfusion. BioRxiv. 2023-03.
17. Damar İ.H., Eroz R., 2022. Argyrophilic nucleolar organizer regions as new biomarkers in ST-Elevation myocardial infarction. Journal of Cardiovascular Development and Disease. 9(2), 58.
18. Santos-Gallego C.G., Picatoste B., Badimón J.J., 2014. Pathophysiology of acute coronary syndrome. Current Atherosclerosis Reports. 16(4), 401.
19. Balan A.I., Halațiu V.B., Scridon A., 2024. Oxidative stress, inflammation, and mitochondrial dysfunction: a link between obesity and atrial fibrillation. Antioxidants. 13(1), 117.
20. Gruzdeva O., Uchasova E., Dyleva Y., Akbasheva O., Matveeva V., Karetnikova V., Kokov A., Barbarash O., 2017. Relationship key factor of inflammation and the development of complications in the late period of myocardial infarction in patients with visceral obesity. BMC Cardiovascular Disorders. 17(1), 36.
21. Miao P., Ruiqing T., Yanrong L., Zhuwen S., Huan Y., Qiong W., Yongnian L., Chao S., 2022. Pyroptosis: a possible link between obesity‐related inflammation and inflammatory diseases. Journal of Cellular Physiology. 237(2), 1245-1265.
22. Ito S., Inoue Y., Nagoshi T., Aizawa T., Kashiwagi Y., Morimoto S., Ogawa K., Minai K., Ogawa T., Yoshimura M., 2025. Cut-off values of Geriatric Nutritional Risk Index for cardiovascular events in Japanese patients with acute myocardial infarction. Heart and Vessels. 40(3), 191-202.
23. Onozato T., Wada H., Ogita M., Abe K., Singh Y.S., Shitara J., Suwa S., Miyauchi K., Minamino T., 2024. Lower low-lipoprotein cholesterol level at the time of acute myocardial infarction is associated with increased cardiovascular events. Circulation, 150(Suppl_1), A4140089-A4140089.
24. Patti G., Cumitini L., Bosco M., Marengo A., D'Amario D., Mennuni M., Solli M., Grisafi L., 2025. Impact of a personalized, strike early and strong lipid-lowering approach on low-density lipoprotein-cholesterol levels and cardiovascular outcome in patients with acute myocardial infarction. European Heart Journal-Cardiovascular Pharmacotherapy. 11(2), 143-154.
25. Brzezinski R.Y., Banai S., Katz Shalhav M., Stark M., GoldinerI., Rogowski O., Shapira I., Zeltser D., Sasson N., Berliner S., Shacham Y., 2024. The CRP troponin test (CTT) stratifies mortality risk in patients with non‐ST elevation myocardial infarction (NSTEMI). Clinical Cardiology. 47(4), e24256.
26. Lawi Z.K.K., Merza F.A., Banoon S.R., Jabber Al-Saady M.A.A., Al-Abboodi A., 2021. Mechanisms of Antioxidant Actions and their Role in many Human Diseases: A Review. Journal of Chemical Health Risks. 11. 10.22034/jchr.2021.683158
27. Kim G.T., Chun Y.S., Park J.W., Kim M.S., 2003. Role of apoptosis-inducing factor in myocardial cell death by ischemia–reperfusion. Biochemical and Biophysical Research Communications. 309(3), 619-624.