دراسة بعض المؤشرات المناعية والكيموحيوية لدى مرضى نقص تروية القلب في محافظة كربلاء

Study of Some Immunological and Biochemical Markers in Patients with Ischemic Heart Diseases in Kerbala Province

abstract

Ischemic heart disease) (IHD) is a disease of the heart triggered by decreased Oxygen allocation to the myocardium It is mainly instigated due to blockage of arteries by the accumulation of cholesterol on walls. Ischemia is the phrase used to define “reduced blood supply. Coronary arteries supply blood to heart muscle, blockage of coronary artery may start to decrease in the blood supply to heart.
The cross sectional study consist (100) samples divided into two main groups (patients groups (85) and control groups (15) In both sex males and females with age range (25-80 years ) Blood sample were collected in a period from March to August 2024 in Imam Al-Hassan Al-Mujtaba Teaching Hospital, and Karbala Center for Heart Diseases and Surgery in Imam Al-Hussein Teaching Hospital in Karbala Province .
In this study, some immunological (Interlukin-35 (IL-35), Interlukin-17A (IL-17A), Forhkead Box P-3 (FOXP3) , and of high-sensitivity C-reactive protein (hs-CRP)), and biochemical (copeptin ,Von Willbrand Factors (VWF),and Troponin I) parameters were monitored in patients and these parameters were determined using enzyme-linked immunosorbent assay (ELISA).
The concentration of troponin I increased significantly (P<0.00001) in Myocardial infraction (0.066 ng/ml ) compared with Stable angina
,unstable angina (0.041, 0.039 ng/ml ) respectively and no significant increase between stable and un stable angina.

The concentration of copeptin gradually increased significant (P < 0.0 0001) in Myocardial infraction (907.75pg/mL) compared with other parameters control ,with risk factors, stable and un stable angina (253.51 ,344.57 ,425.18 , 517.57pg/ml ) respectively.
and also unstable angina (517.57 pg/ml ) was increased significant (P< 0.05) compared with stable angina ( 425.18 pg/ml).
The concentration of VWF increased significantly (P<0.00001) in Myocardial infraction (4.57 ng/ml ) compared with other parameters ( control, with risk factors, Stable angina ,unstable angina (0.24, 0.94, 1.44 , 2.92 ng/ml ) respectively and also unstable angina (2.92 ng/ml ) is significant increasing (P<0.00001) compared with stable angina (1.44 ng/ml).
The concentration of hs-CRP increased significantly (P<0.00001) in unstable angina and continually highly increasing in myocardial infraction ( 417.75, 782.60 pg/ml ) respectively compared with other parameters ( control, with risk factors, stable angina (117.21, 249.77, 200.00 pg/ml ) respectively this result indicate hs-CRP as predictor to myocardial infraction .
The concentration of Foxp3 increased significantly (p<0.00001) in unstable angina and continually highly significant increasing in myocardial infraction (5.51 ,10.64 ng/ml) respectively compared with other parameters ( control, with risk factors, stable angina) (1.48, 2.83, 3.68 ng/ml ) respectively this result indicate the Foxp3 as predictor to myocardial infraction.
The concentration of IL-17A highly increased significantly (p < 0.00001) in unstable angina and continually significant increasing in myocardial infraction (491.64, 944.38pg/ml ) respectively compared with

other parameters ( control ,with risk factors, Stable angina (91.40, 333.70, 258.56 pg/ml ) respectively, this result indicated the IL17 as indicator to myocardial infraction.
The concentration of IL-35 highly decreased significantly (p <0.00001) in myocardial infraction (146.15 pg/ml ) compared with group control (405.90pg/ml) and all so decreased significant with other parameters, ( with risk factor ,Stable angina ,unstable angina (157.87, 160.96, 160.35pg/ml ) respectively.
The study was indicated that increased serum concentrations of hs-CRP, IL-17A, and FoxP3, along with a reduction in IL-35 levels, in patients with stable angina, unstable angina, and myocardial infarction. Furthermore, the concentration of Troponin I was significantly higher in myocardial infarction compared to other conditions (including those control, with risk factors, stable angina, and unstable angina), highlighting its potential as a key biomarker for myocardial injury. Additionally, Copeptin was significantly elevated in unstable angina, and its levels continued to rise significantly in myocardial infarction. The study also suggested that von willbrand factor may serve as a predictive biomarker, as it significantly increased in unstable angina and continued to rise markedly in myocardial infarction.