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Article Type

Original Study

Abstract

Objective The aim of this study was to evaluate the role of circulating cell-free DNA as an early cardiac biomarker in patients with acute myocardial infarction (AMI). Background Circulating cell-free DNA mainly originates from programmed cell death or acute cellular injury and reflects the extent of cellular damage. Patients and methods This study was carried out on AMI patients (n = 50) and healthy controls (n = 30). All participants were subjected to a full assessment of history, clinical examination, ECG, and echocardiography. Blood samples were taken for cardiac biomarkers, kidney function tests, liver enzymes, lipid profiles, and real-time quantitative PCR for cell-free DNA at the first and the third day of AMI attacks. Results AMI patients had significantly higher levels of cardiac markers, total cholesterol, triglyceride, low-density lipoprotein, L1PA2-222, L1PA2-90, and L1PA2-222/L1PA2-90 ratio versus controls. There was a significantly higher peak on the first day of the attack in L1PA2-90 and L1PA2-222 cell-free DNA levels and the L1PA2-222/L1PA2-90 ratio in AMI patients and a gradual decrease on the third day, without a nonsignificant difference between ST-elevation and non-ST-elevation myocardial infarction. There were nonsignificant correlations between the concentration of cell-free DNA parameters and clinical, echocardiography, or laboratory parameters. The diagnostic validity for the L1PA2-222/L1PA2-90 cfDNA ratio on the first day of an AMI attack was significantly higher (P < 0.001) at the cutoff point of 0.61 with a sensitivity of 54% and a specificity of 87%; there was a gradual decrease on the third day of attacks. Conclusion Elevated cell-free DNA can be used as an early cardiac biomarker in AMI patients and may complement traditional cardiac troponin-I and creatine kinase-MB biomarkers in the diagnosis of AMI.

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