Potential Molecular Biomarkers for Prediction of Coronary Artery Disease, its Severity and Extent

Document Type : Original Article

Authors

1 Department of Medical Biochemistry, Faculty of Medicine, Benha University, Benha - Egypt.

2 Department of Cardiovascular medicine, Faculty of Medicine, Benha University, Benha - Egypt.

Abstract

Coronary artery disease (CAD) has high morbidity and mortality, therefore accurate detection of CAD and atherosclerotic plaque burden is essential. Invasive coronary angiography (ICA) can confirm the presence of luminal stenosis caused by atherosclerotic plaque and is an important tool for the quantification of CAD plaque burden. However, it has many limitations. Therefore, new methods for accurate noninvasive diagnosis of CAD using genetic markers were exerted. This study aimed at evaluation of new genetic biomarkers in diagnosing CAD and determining its severity and extent, using Gensini score as a scoring model. Sixty two subjects who had undergone coronary angiography and analyzed for the presence, severity and extent of CAD using Gensini score were selected for this study. Twenty subjects had normal Gensini score, 24 subjects were with mild to moderate CAD and 18 subjects were with severe CAD. Extraction of total RNA from whole blood was done together with PCR amplification of PNPLA2, TUBA3, FTL and AHR genes and the house keeping gene GAPDH. It was found that PNPLA2 and TUBA3 were significantly lower in CAD patients and mild/moderate CAD than in controls. However, PNPLA2 was significantly higher in severe CAD than in mild/moderate CAD. Moreover, PNPLA2 gene had The highest specificity for CAD prediction of (100%), followed by TUBA3 (60%) then FTL and AHR (each 40%), and both PNPLA2 and FTL gene had the highest sensitivity for CAD diagnosis (80.95%), followed by TUBA 3 (76.19%), then AHR (71.43%). On the other hand, PNPLA2 showed the highest specificity in CAD severity prediction (83.33%), followed by TUBA3, FTL and AHR with equal specificity (each 50%), and TUBA 3 showed the highest sensitivity (66.67%) followed by PNPLA2,, FTL and AHR with equal sensitivity (each 55.56%). In conclusion, these genes are useful in prediction of CAD and CAD severity especially emphasizing PNPLA2 and TUBA3 and further studies on larger population number and other genes are recommended.

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