المستخلص
Heart attacks, commonly referred to as myocardial infarction (MI), continue to rank among the world’s leading causes of death., with oxidative stress playing a key role in myocardial tissue damage and necrosis. Ischemia-Modified Albumin (IMA) and Glutathione Peroxidase (GPx) have been identified as potential biomarkers for diagnosing and assessing MI severity. Additionally, “trace elements such as Zinc” (Zn), Selenium (Se) play a crucial role in antioxidant defense mechanisms, but in contrast, Total Antioxidant Capacity (TAC) and The capacity of 2,2-Diphenyl-1-Picrylhydrazyl (DPPH) to remove radicals provide complementary data regarding the presence of oxidative stress and Cardiovascular Diseases(CVD). Understanding the relationship between these biomarkers and oxidative stress could enhance early diagnosis and prognosis in Ischemic Heart Disease(IHD). This study aims at investigating relationships between IMA, oxidative stress, and antioxidant system and the occurrence of ischemic heart disease. Specifically, it evaluates the association between trace elements (Zn, Se) and cardiac biomarkers (IMA, GPx) and examines their potential roles in MI pathogenesis and prognosis. Furthermore, it assesses the significance of (TAC) and (DPPH) in oxidative stress balance and their correlation with cardiac health.
The study was conducted at Baquba Teaching Hospital in Diyala Governorate from 1/1/ 2024, to 1/1/2025. It included 80 patients diagnosed with myocardial infarction who were hospitalized in the Cardiac Care Unit (CCU). Diagnosis was confirmed by a specialist physician based on clinical evaluation, electrocardiographic changes, and elevated cardiac biomarkers. Patients included in the study had experienced symptoms for no more than six hours prior to sample collection. The mean cohort of male (40) and female (40) participants was 59.31± 61.4 years. To make a comparison, there were 80 healthy individuals aged at 61.4 . Serum IMA and GPx were
measured using an ELISA kit, while( TAC, DPPH), total protein, albumin, and trace elements (Zn, Se) were assessed spectrophotometrically.
The results of the study revealed that:
- myocardial infarction (MI) patients showed significantly higher levels of IMA compared to controls.
- Levels of (DPPH, Zn, Se, TAC)and (GPx) activity were significantly decreased (p < 0.001).
- No direct correlation was found between( IMA) and (DPPH, TAC, total protein, or albumin).
- Significant positive correlations were observed between:
- TAC and DPPH (r = 0.678, p < 0.001)
- Total protein and albumin (r = 0.640, p < 0.001)
- TAC and albumin (r = 0.575, p < 0.001)
- An inverse relationship was observed between DPPH quenching and protein levels.
- Zn and Se levels were decreased in MI patients.
List of Contents
List of Table. VIII
List of Symbols and Abbreviations XIII
1.2 Heart Disease Coronary Arteries 2
1.2.1 Angina pectoris………………………………………………………3
1.2.2 Myocardial infarction….. 3
1.3 Factors that Contribute to Heart Disease. 5
1.3.2 Factors that can be controlled include. 7
1.5 Types of Free radical Reactions 9
1.5.1 Reaction of Free Radical with Free Radical 9
1.5.2 Free Radical with other compounds 9
1.6- Free Radicals and Heart Disease. 10
1.10 Ischemia-Modified Albumin (IMA) 14
1.11 Ischemia-Modified Albumin (IMA) and Heart Disease 15
1.14 The disorders Related Albumin. 19
1.16 Glutathione Peroxidase (GPx) 22
1.17 Total Antioxidant Capacity (TAC) 23
1.18 1,1-diphenyl-2-picrylhydrazil (DPPH) 24
1.19 The aim of This Study. 26
Chapter Two: Literature review……………………………………………
3.1 Instruments and Materials 31
3.1.2 Materials and Chemicals 31
3.3 Collection of Blood Samples 33
3.4.1 Measurement of IMA levels in Human serum by using Sandwich-ELISA Technique 33
3.4.1.2 Materials provided with the kit 34
3.4.1.3 Preparation of reagents 35
3.4.1.4 Calculation of results 37
3.4.2 Measurement of GPX levels in Human serum by using Sandwich-ELISA Technique 37
3.4.2.2 Reagent preparation. 39
3.4.2.4 Calculation of results 42
3.4.3 Measurement of DPPH levels in Human serum by using Bio Chemical Technique 43
3.4.3.1 principle…………………………………………………………………. 43
3.4.3.2 Materials prepared by users…………………………………………. 44
3.4.3.3 Reagent preparation…………………………………………………… 44
3.4.3.4 Calculation”…………………………………………………………….. 45
3.4.4 Measurement of TAC levels in Human serum by using Bio Chemical Technique 46
3.4.4.1 principle………………………………………………………………….. 46
3.4.4.2 Materials prepared by users…………………………………………. 47
3.4.4.3 Reagent preparation………………………………………………….. 48
3.4.4.4 Calculation………………………………………………………………. 48
3.4.5 Measurement of Total Protein levels in Human serum by using Bio Chemical Technique…………………………………………………………………………. 50
3.4.5.1 Principle…………………………………………………………………. 50
3.4.5.2 Instrumentation and Materials……………………………………. 51
3.4.5.3 Automated Procedure””…………………………………………….. 51
3.4.5.4 Calibration”…………………………………………………………….. 51
3 3.4.5.5 Results””……………………………………………………………… 51
3.4.6 Measurement of Albumin levels in Human serum by using Bio Chemical Technique……………………………………………………………………………………….. 52
3.4.6.1 Principle…………………………………………………………………. 52
3.4.6.2 Reagent Composition……………………………………………….. 52
3.4.6.3“Materials Required””………………………………………………… 53
3.4.6.4 Procedure””……………………………………………………………. 53
3.4.6.5 Calculation……………………………………………………………… 53
3.4.7 Measurement of Selenium levels in Human serum by using Bio Chemical Technique……………………………………………………………………………………….. 54
3.4.7.1 Principle…………………………………………………………………. 54
3.4.7.2 Materials…………………………………………………………………. 54
3.4.7.3 Sample Preparation…………………………………………………… 55
3.4.7.4 Assay Procedure………………………………………………………. 56
3.4.8-Measurement of Zinc levels in Human serum by using Bio Chemical Technique 55
3.4.8.3 Sample Preparation. 56
3.4.8.4 Standard Curve Preparation. 57
4.1 Anthropometries Measurements 59
4.2 Ischemia Modified Albumin Studies 59
4.3 Diagnostic Accuracy of Ischemic Modified Albumin (IMA) 61
4.4 Glutathione Peroxidase Studies 63
4.5 Diagnostic Accuracy of GPx. 64
4.6.1 Total antioxidant capacity (TAC) parameters studies 66
4.6.1.1 Diagnostic accuracy of total antioxidant capacity (TAC) 68
4.6.2 DPPH parameters studies………………………………………………… 69
4.6.2.1 Diagnostic accuracy of DPPH.. 69
4.7 Proteins Parameters Studies 70
4.8 Diagnostic Accuracy of T.P and S.ALB. 71
4.9 Trace Elements Determination(Zn,Se) 72
4.10 Diagnostic Accuracy of Se and Zn. 75
4.11 Correlation between the Parameters 76
Chapter Five: Conclusions & Recommendations…………………………….. Conclusion …….………….81
Reference……………………………………………………………………. 83
