Vibration-Controlled Transient Elastography-Based Parameters Predict Clinical Outcomes in Liver Transplant Recipients.

BACKGROUND AND AIMS: Vibration-controlled transient elastography (VCTE) is used in clinical practice to risk-stratify liver transplant (LT) recipients; however, there are currently little data demonstrating the relationship between VCTE and clinical outcomes. METHODS: A total of 362 adult LT recipients with successful VCTE examination between 2015 and 2022 were included. Presence of advanced fibrosis was defined as liver stiffness measurement (LSM) ≥10.5 kPa and hepatic steatosis as controlled attenuation parameter (CAP) ≥270 dB/m. The outcomes of interest included all-cause mortality, myocardial infarction (MI), and graft cirrhosis using cumulative incidence analysis that accounted for the competing risks of these outcomes. RESULTS: The LSM was elevated in 64 (18%) and CAP in 163 (45%) LT recipients. The baseline LSM values were similar in patients with elevated vs normal CAP values. After a median follow-up of 65 (interquartile range, 20-140) months from LT to baseline VCTE, 66 (18%) patients died, 12 (3%) developed graft cirrhosis, and 18 (5%) experienced an MI. Baseline high LSM was independently associated with all-cause mortality (hazard ratio [HR], 1.97; 95% confidence interval [CI], 1.11-3.50; P = .02) and new onset cirrhosis (HR, 6.74; 95% CI, 2.08-21.79; P < .01). A higher CAP value was significantly and independently associated with increased risk of experiencing a MI over study follow-up (HR, 4.14; 95% CI, 1.29-13.27; P = .017). CONCLUSIONS: The VCTE-based parameters are associated with clinical outcomes and offer the potential to be incorporated into clinical risk-stratification strategies to improve outcomes among LT recipients.

Methodological identification of anomalies episodes in ECG streams: a systematic mapping study.

An electrocardiogram is a medical examination tool for measuring different patterns of heart blood flow circle either in the form of usual or non-invasive patterns. These patterns are useful for the identification of morbidity condition of the heart especially in certain conditions of heart abnormality and arrhythmia. Myocardial infarction (MI) is one of them that happened due to sudden blockage of blood by the cause of malfunction of heart. In electrocardiography (ECG) intensity of MI is highlighted on the basis of unusual patterns of T wave changes. Various studies have contributed for MI through T wave's classification, but more to the point of T wave has always attracted the ECG researchers. Methodology. This Study is primarily designed for proposing the combination of latest methods that are worked for the solutions of pre-defined research questions. Such solutions are designed in the form of the systematic review process (SLR) by following the Kitchen ham guidance. The literature survey is a two phase's process, at first phase collect the articles that were published in IEEE Xplore, Scopus, science direct and Springer from 2008 to 2023. It consist of steps; the first level is executed by filtrating the articles on the basis of keyword phase of title and abstract filter. Similarly, at two level the manuscripts are scanned through filter of eligibility criteria of articles selection. The last level belongs to the quality assessment of articles, in such level articles are rectified through evaluation of domain experts. Results. Finally, the selected articles are addressed with research questions and briefly discuss these selected state-of-the-art methods that are worked for the T wave classification. These address units behave as solutions to research problems that are highlighted in the form of research questions. Conclusion and future directions. During the survey process for these solutions, we got some critical observations in the form of gaps that reflected the other directions for researchers. In which feature engineering, different dependencies of ECG features and dimensional reduction of ECG for the better ECG analysis are reflection of future directions.

AlphaLISA-Based Immunoassay for Detection of Troponin T in Serum of Patients with Acute Myocardial Infarction.

Survival and prognosis of patients with acute myocardial infarction (AMI) are highly dependent on rapid and accurate diagnosis of myocardial damage. Troponin T is the primary diagnostic biomarker and is widely used in clinical practice. Amplified luminescent proximity homogeneous assay (AlphaLISA) may provide a solution to rapidly detect a small amount of analyte through molecular interactions between special luminescent donor beads and acceptor bead. Here, a double-antibody sandwich assay was introduced into AlphaLISA for rapid detection for early diagnosis of AMI and disease staging evaluation. The performance of the assay was evaluated. The study found that the cTnT assay has a linear range of 48.66 to 20,000 ng/L with a limit of detection of 48.66 ng/L. In addition, the assay showed no cross-reactivity with other classic biomarkers of myocardial infarction and was highly reproducible with intra- and inter-batch coefficients of variation of less than 10%, notably, only 3 min was taken, which is particularly suitable for clinical diagnosis. These results suggest that our method can be conveniently applied in the clinic to determine the severity of the patient's condition.

Antibody-functionalized gold nanoclusters/gold nanoparticle platform for the fluorescence turn-on detection of cardiac troponin I.

A selective fluorescence turn-on immunosensor for the specific detection of cardiac troponin I (cTnI), the potent biomarker for myocardial infarction diagnosis, was developed with a nano couple comprised of protein-stabilized gold nanocluster and gold nanoparticle. The red fluorescence of cTnI-specific antibody tagged bovine serum albumin stabilized gold nanoclusters was quenched with gold nanoparticles (AuNP) via the intensive interaction between amine and hydroxyl functionalities of BSA and AuNP. Through this, the adsorption of gold nanoclusters at the surface of AuNP, resulting in a core-satellite assembly, was assumed to quench the fluorescence emission. While in the presence of cTnI antigen, this gets disturbed due to the formation of immunocomplex between cTnI antigen and antibody, which restricts the close interaction between gold clusters and nanoparticles, thereby restoring quenched fluorescence. The enhancement in fluorescence signal is directly related to the concentration of cTnI, and this facilitates the selective detection of cTnI in the linear concentration range 0.7 to 10 ng/mL without any interference from other potentially interfering co-existing biomolecules. An appreciable limit of detection of 0.51 ng/mL and a limit of quantification of 0.917 ng/mL for cTnI is comparable to that of the previous report.

The Effect of Iodinated Contrast Media Sensitivity on the Prognosis of Patients with STEMI.

Background and Objectives: Iodinated Contrast Media (ICM) is used daily in many imaging departments worldwide. The main risk associated with ICM is hypersensitivity. When a severe hypersensitivity reaction is not properly managed and treated swiftly, it may be fatal. Currently, there is no data to demonstrate how ICM sensitivity affects the prognosis of cardiac patients, especially those diagnosed with ST elevation myocardial infarction (STEMI), in whom urgent coronary angiography is indicated. This study aimed to identify and characterize this relationship. Materials and Methods: We included patients hospitalized with STEMI between 2016 and 2019 from the National Inpatient Sample. The population was compared based on ICM sensitivity status, sensitive vs. non-sensitive. The primary endpoint was in-hospital mortality, with additional endpoints: length of stay and in-hospital complications. Results: The study included 664,620 STEMI patients, of whom 4905 (0.7%) were diagnosed with ICM sensitivity. ICM-sensitive patients were older, more often white, females, and had more comorbidities and cardiovascular risk factors. Both groups show similarities in management but are slightly less probable to undergo PCI or CABG. Multivariable logistic regression models found that the ICM-sensitive population had similar odds of in-hospital mortality (OR: 1.02, 95% CI: 0.89-1.16) and MACCE (OR: 1.05, 95% CI: 0.95-1.16), and less major bleeding (OR: 0.73, 95% CI: 0.60-0.87). Conclusions: Our study found that ICM sensitivity status was not a significant factor for worse prognosis in patients hospitalized with STEMI.

Electrocardiographic changes in acute myocardial infarction with acute occlusion of all triple coronary arteries.

The 66-year-old woman was diagnosed with "acute myocardial infarction" due to acute triple vessel occlusion based on clinical symptoms, laboratory examination, and coronary angiography (CAG), but her ECG showed ST-segment depression in leads aVR and aVL, in addition to ST-segment elevation in a wide range of leads (V1-V9, V3R-V5R, II, III, and aVF). Thus, a perfect explanation with the existing theory is difficult, and only the case is presented here.

Regulation of a Novel CircTRRAP/miR-761/MAP3K2 CeRNA Cascade in Inflammation, Apoptosis, and Oxidative Stress in Human AC16 Cardiomyocytes under Hypoxia Conditions.

Emerging evidence uncovers the important involvement of circular RNAs (circRNAs) in the dysfunction of cardiomyocytes under hypoxia conditions. However, no studies proved whether circTRRAP (hsa_circ_0081241) can participate in cardiomyocyte injury evoked by hypoxia.A qRT-PCR or immunoblotting method was used to evaluate the expression of circTRRAP, miR-761, and mitogen-activated protein kinase kinase kinase 2 (MAP3K2). The direct relationships of circTRRAP/miR-761 and miR-761/MAP3K2 were confirmed by RNA immunoprecipitation (RIP) assay, dual-luciferase reporter assay, and RNA pull-down assay. The effects of the circTRRAP/miR-761/MAP3K2 axis on cell functional behaviors were examined by 5-ethynyl-2'-deoxyuridine (EdU) assay, CCK-8 assay, and flow cytometry. The production levels of proinflammatory cytokines (IL-1ß, TNF-α, and IL-6) were evaluated by enzyme-linked immunosorbent assay.CircTRRAP and MAP3K2 were overexpressed but miR-761 was downregulated in AC16 cardiomyocytes under hypoxia and in the serum of patients with acute myocardial infarction. Silencing circTRRAP attenuated hypoxia-evoked inflammation, apoptosis, and oxidative stress in human AC16 cardiomyocytes. CircTRRAP targeted miR-761, and miR-761 directly targeted and suppressed MAP3K2. CircTRRAP involved the post-transcriptional regulation of MAP3K2 through miR-761, indicating its competing endogenous RNA (ceRNA) activity. Moreover, miR-761 inhibition abolished the effects of circTRRAP depletion in hypoxia-induced cell injury. MAP3K2 silencing phenocopied miR-761 increase in attenuating hypoxia-evoked cardiomyocyte inflammation, apoptosis, and oxidative stress.Our study demonstrates that circTRRAP can protect AC16 cardiomyocytes from hypoxia-evoked injury through the miR-761/MAP3K2 axis.

Cardiovascular and haematological events post COVID-19 vaccination: A systematic review.

Since COVID-19 took a strong hold around the globe causing considerable morbidity and mortality, a lot of effort was dedicated to manufacturing effective vaccines against SARS-CoV-2. Many questions have since been raised surrounding the safety of the vaccines, and a lot of media attention to certain side effects. This caused a state of vaccine hesitancy that may prove problematic in the global effort to control the virus. This review was undertaken with the aim of putting together all the reported cardiovascular and haematological events post COVID-19 vaccination in published literature and to suggest possible mechanisms to explain these rare phenomena.

Invited Commentary: Mechanistic and Biologically Based Models in Epidemiology-A Powerful Underutilized Tool.

Mechanistic and biologically based mathematical models of chronic and behavioral disease processes aim to capture the main mechanistic or biological features of the disease development and to connect these with epidemiologic outcomes. These approaches have a long history in epidemiologic research and are complementary to traditional epidemiologic or statistical approaches to investigate the role of risk factor exposures on disease risk. Simonetto et al. (Am J Epidemiol. 2022;191(10):1766-1775) present a mechanistic, process-oriented model to investigate the role of smoking, hypertension, and dyslipidemia in the development of atherosclerotic lesions and their progression to myocardial infarction. Their approach builds on and brings to cardiovascular disease the ideas and perspectives of earlier mechanistic and biologically based models for the epidemiology of cancer and other chronic diseases, providing important insights into the mechanisms and epidemiology of smoking related myocardial infarction. We argue that although mechanistic modeling approaches have demonstrated their value and place in epidemiology, they are highly underutilized. We call for efforts to grow mechanistic and biologically based modeling research, expertise, and awareness in epidemiology, including the development of training and collaboration opportunities to attract more students and researchers from science, technology, engineering, and medical field into the epidemiology field.

Spontaneous left main coronary artery dissection occurred in a young male: a case report and review of literature.

BACKGROUND: Spontaneous coronary artery dissection (SCAD) is now recognized as an important cause of acute coronary syndrome (ACS), which is thought to be more prevalent in women. However, the male patients, on the other hand, cannot be easily ignored. CASE PRESENTATION: A 26-year-old male suffered from SCAD that occurred in the left main coronary artery (LMCA) and a secondary acute myocardial infraction (AMI). Coronary CT angiography and coronary angiography (CAG) revealed aneurysms in the LMCA and right coronary artery (RCA), as well as a total occlusion in the proximal branch of the left anterior descending artery (LAD). Along with drug therapy, coronary artery bypass graft (CABG) surgery was recommended, and the patient has been symptom-free for one year. CONCLUSION: We report a case of spontaneous left main coronary artery dissection that occurred in a young male. The necessity of identifying typical imaging features and following up patients with SCAD for life to reduce the risk of fatal cardiac complications cannot be overstated.

Machine Learning Methods in Predicting Patients with Suspected Myocardial Infarction Based on Short-Time HRV Data.

Diagnosis of cardiovascular diseases is an urgent task because they are the main cause of death for 32% of the world's population. Particularly relevant are automated diagnostics using machine learning methods in the digitalization of healthcare and introduction of personalized medicine in healthcare institutions, including at the individual level when designing smart houses. Therefore, this study aims to analyze short 10-s electrocardiogram measurements taken from 12 leads. In addition, the task is to classify patients with suspected myocardial infarction using machine learning methods. We have developed four models based on the k-nearest neighbor classifier, radial basis function, decision tree, and random forest to do this. An analysis of time parameters showed that the most significant parameters for diagnosing myocardial infraction are SDNN, BPM, and IBI. An experimental investigation was conducted on the data of the open PTB-XL dataset for patients with suspected myocardial infarction. The results showed that, according to the parameters of the short ECG, it is possible to classify patients with a suspected myocardial infraction as sick and healthy with high accuracy. The optimized Random Forest model showed the best performance with an accuracy of 99.63%, and a root mean absolute error is less than 0.004. The proposed novel approach can be used for patients who do not have other indicators of heart attacks.

Association of Dietary Diabetes Risk Reduction Score With Risk of Cardiovascular Diseases in the Iranian Population: Tehran Lipid and Glucose Study.

BACKGROUND: There are no data available regarding the association of dietary diabetes risk reduction score (DDRRS) and risk of cardiovascular disease (CVD) worldwide. We aimed to investigate the association of the DDRRS with the risk of CVD outcomes in a prospective population-based study. METHOD: Individuals without CVD (n=2,195) were recruited from participants of the Tehran Lipid and Glucose Study (2006-2008) and followed for a mean of 6.7 years. The DDRRS was determined on the basis of eight components using a validated 168-item food frequency questionnaire. Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate the hazard ratios and 95% confidence interval (CI) of CVD across quartiles of DDRRS. RESULTS: The mean ± standard deviation age of participants (44.8% male) was 38.8±13.0 years at baseline. Median DDRRS for all patients was 23 (intequartile range 20-26). During follow-up, 77 (3.5%) new cases of CVD were identified. After adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, energy intake, diabetes, and hypertension, no association was found between DDRRS and risk of CVD (odds ratio, 0.70; 95% CI, 0.36-1.37 [p-value for trend=0.351]). CONCLUSIONS: The findings of this study showed that higher DDRRS is not associated with risk of CVD events.

Effect of stress management training in cardiac rehabilitation among coronary artery disease: a systematic review and meta-analysis.

The stress management program is not considered as a part of routine cardiac rehabilitation due to the lack of consensus and inconsistencies in the studies detailing the relation between stress and coronary artery disease. The current meta-analysis is intended to determine the effectiveness of stress management in cardiac rehabilitation. The published literature studies until December 2020 were extracted from various databases and eligible studies were selected based on the inclusion and exclusion criteria. Quality assessment of the selected studies was carried out using Jadad. The literature search of various databases yielded 154 studies and 9 were selected based on the inclusion/exclusion criteria. On the Jadad scale, 6 studies obtained a score of 3, whereas the remaining studies obtained a score of 2. Funnel plot findings reported no publication bias. The result of the meta-analysis showed a persistent improvement in Beck depression inventory-2, hospital anxiety scale and hospital depression scale in subjects who had undergone various stress management interventions. The meta-analysis corroborates the benefits of stress management training in cardiac rehabilitation and underscores the need to adopt a stress management program in routine cardiac care.

Ticagrelor Exerts Immune-Modulatory Effect by Attenuating Neutrophil Extracellular Traps.

Neutrophils through the release of neutrophil extracellular traps (NETs) containing active tissue factor (TF) are key components of thrombo-inflammation. Platelets-neutrophils interplay in ST elevation myocardial infarction (STEMI) promotes NET formation via inorganic polyphosphates (polyP) released by thrombin-activated platelets. NETs, however, are also induced by biomaterials in a platelet-independent manner. Considering the possible pleiotropic effects of Ticagrelor beyond platelet inhibition and the clinical need for novel antithrombotic strategies targeting inflammation, we investigated the effects of Ticagrelor on polyP and stent-induced NETs in STEMI. Neutrophils from healthy individuals and patients receiving Ticagrelor were stimulated with polyP or drug-eluting stents (DES) to produce NETs. To induce TF expression, neutrophils were further incubated with plasma obtained from the infarct-related artery (IRA) of STEMI patients. The effects of Ticagrelor on NETs and TF loading were assessed using fluorescence microscopy, flow cytometry, myeloperoxidase(MPO)/DNA complex ELISA, and a Western blot. Ticagrelor interrupts platelet-neutrophil interaction by attenuating NETs induced by polyP. However, Ticagrelor does not affect polyP secretion from thrombin-activated platelets. Similarly, the intracellular production of TF in neutrophils triggered by IRA plasma is not hindered by Ticagrelor. Furthermore, DES induce NETs and synchronous stimulation with IRA plasma leads to the formation of thrombogenic TF-bearing NETs. Ticagrelor inhibits stent-induced NET release. These findings suggest a novel immune-modulatory effect of Ticagrelor when it attenuates the formation of thrombogenic NETs.

The Association of Fractional Pulse Pressure with Acute Kidney Injury in Patients Undergoing Coronary Intervention due to ST-Segment Elevated Myocardial Infarction.

OBJECTIVE: Acute kidney injury (AKI), which is prevalent in ST-segment elevated myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (PCI), is associated with poor cardiovascular outcomes. As high pulse pressure (PP) is associated with adverse cardiovascular events, the present study's aim was to evaluate the relationship between fractional PP (PPf) and AKI in patients with STEMI who underwent primary PCI. SUBJECTS AND METHODS: All laboratory findings as well as echocardiographic and angiographic data of 1,170 consecutive STEMI patients were retrospectively screened. PPf was calculated from the pressures invasively measured after sheath insertion and before performing coronary angiography. RESULTS: From 1,170 eligible STEMI patients (mean age 56 years, 18.2% female), AKI developed in 143 (12.2%) patients. The PPf and pulsatility index were significantly higher in patients with AKI than those without (0.53 ± 0.10 vs. 0.61 ± 0.10, p < 0.001, and 0.80 ± 0.03 vs. 0.82 ± 0.03, p < 0.001, respectively). PPf was also found to be associated with AKI in univariable (OR 2.183, 95% CI 1.823-2.614, p< 0.001) and multivariable (OR 1.874, 95% CI 1.513-2.322, p < 0.001) analysis. In-hospital mortality was higher in patients with AKI than those without. CONCLUSION: Invasively measured PPf, which can be easily measured and has no additional cost in STEMI patients undergoing coronary intervention, is an independent predictor of AKI. In addition, PPf is superior to other blood pressure values and derivatives in AKI prediction.

D-Limonene mitigate myocardial injury in rats through MAPK/ERK/NF-κB pathway inhibition.

Cardiovascular diseases are the primary reason of mortality, among which myocardial infarction (MI) is the most dominant and prevalent. This study was considered to examine D-Limonene protective action against isoproterenol (ISO) induced MI. Wister male rats were dispersed into four groups. Normal and D-Limonene control group in which rats administered saline or D-Limonene. ISO control animals were administered saline for 21 days then challenged with ISO (85 mg/kg, subcutaneously) on 20th and 21st day for MI induction. D-Limonene pretreated group in which animals were pretreated with D-Limonene 50 mg/kg orally for 21 days then administered ISO on 20th and 21st day. MI prompted variations were assessed by myocardial infarction area determination, blood pressure (BP) alterations, cardiac injury biomarkers and inflammatory mediators measurements. For more depth investigation, both the apoptotic status was evaluated via measuring mRNA expression of Bcl-2 and Bax as well as mitogen-activated protein kinase-extracellular signal-regulated kinase (MAPK-ERK) signal transduction were investigated via Western blotting. MI group revealed significant infarcted area, blood pressure alterations, myocardial injury enzymes intensification together with inflammatory cytokines amplification. MI was associated with activation of MAPK-ERK signal pathway and apoptotic status within the myocardium. On the other hand, pretreated with D-Limonene demonstrated deterred infracted area, reduced myocardial enzymes, improved BP indices, lessened inflammatory levels. Furthermore, D-Limonene pretreatment caused a decline in MAPK proteins pathway and Bax relative mRNA expression, while intensifying Bcl-2 mRNA expression promoting that D-Limonene may constrain MI induced myocardial apoptosis. D-Limonene mitigated MI injury through MAPK/NF-κB pathway inhibition and anti-apoptotic effect.

Stem cell therapy: A novel approach for myocardial infarction.

Myocardial infarction (MI) is a major cause of morbidity and mortality worldwide. Until recently, it was thought that myocardium was not able to repair itself, but studies have now shown that resident cardiac stem cells have regenerative capacity, and stem cell therapy may be a novel approach for cardiac muscle repair and regeneration. Stem cell-derived paracrine factors have been shown to regulate ventricular remodeling, inflammation, apoptosis, cardiomyocytes regeneration, and neovascularization in regions of infarcted cardiac tissue. In this review, we summarize the evidence from cellular, animal, and clinical studies supporting the potential clinical significance of stem cell therapy as a novel therapeutic approach for the treatment of MI.

In a Nutshell: Findings from the Bruneck Study.

The Bruneck Study is a prospective community-based study enrolling an age- and sex-stratified random sample of 1,000 men and women. It achieved an extraordinary participation rate of 93.4% and a near-complete long-term follow-up exceeding a quarter of a century (1990-2018). High-quality ascertainment of most common human diseases enables reliable evaluation of: disease epidemiology, overlaps between age-related diseases, and risk factors, and discovery of novel biomarkers. Research priorities include atherosclerosis, cardiovascular disease, aging and longevity, neurological diseases, disorders of the bone, and cancer. This review summarizes the main scientific contributions of the Bruneck Study over the past decades, outlines recent highlights, and gives an outlook of what is planned next.

Downregulation of S100A4 Alleviates Cardiac Fibrosis via Wnt/ß -Catenin Pathway in Mice.

BACKGROUND/AIMS: Cardiac fibrosis is a pathological change leading to cardiac remodeling during the progression of myocardial ischemic diseases, and its therapeutic strategy remains to be explored. S100A4, a calcium-binding protein, participates in fibrotic diseases with an unclear mechanism. This study aimed to investigate the role of S100A4 in cardiac fibrosis. METHODS: Cardiac fibroblasts from neonatal C57BL/6 mouse hearts were isolated and cultured. Myocardial infarction was induced by ligating the left anterior descending coronary artery (LAD). The ligation was not performed in the sham group. A volume of 5×105pfu/g adenovirus or 5 µM/g ICG-001 was intramyocardially injected into five parts bordering the infarction zone or normal region. We used Western blotting, quantitative RT-PCR, immunofluorescence, immunohistochemistry and Masson's trichrome staining to explore the function of S100A4. RESULTS: We found significant increases of S100A4 level and cardiac fibrosis markers, and ß-catenin signaling activation in vitro and in vivo. In addition, knockdown of S100A4 significantly reduced cardiac fibrosis and ß-catenin levels. Moreover, the expression of S100A4 decreased after ICG-001 inhibited ß-catenin signal pathway. CONCLUSION: Downregulation of S100A4 alleviates cardiac fibrosis via Wnt/ß -catenin pathway in mice. S100A4 may be a therapeutic target of cardiac fibrosis.

Prognostic Value of sLOX-1 Level in Acute Coronary Syndromes Based on Thrombolysis in Myocardial Infarction Risk Score and Clinical Outcome.

BACKGROUND: Biomarkers possess important diagnostic and prognostic value in acute coronary syndromes (ACSs). Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) is one of the markers involved in atherosclerotic plaque vulnerability and rupture. OBJECTIVE: This study aimed to evaluate the prognostic value of sLOX-1 through its correlation with Thrombolysis in Myocardial Infarction (TIMI) risk score and its possible association with clinical outcomes in 2 major spectrums of ACS. METHODS: A prospective cross-sectional study was planned, and 320 patients who underwent diagnostic coronary angiography were selected (in first 24 h after coronary angiography): those with documented ST elevation myocardial infarction or unstable angina/non-ST elevation myocardial infarction. sLOX-1 was measured immediately after administration in the emergency department. The TIMI risk score was calculated separately for both groups. In hospital death, heart failure and recurrent infarction were considered major adverse cardiac events. RESULTS: There was a significant positive correlation between sLOX-1, TIMI risk score, major adverse cardiac events, and heart failure. The optimal cutoff value of sLOX-1 to predict clinical endpoints was 1.75 ng/mL in patients with ST elevation myocardial infarction and 1.35 ng/mL in patients with unstable angina/non-ST elevation myocardial infarction. CONCLUSIONS: Circulating sLOX-1 could be used as a biomarker to predict major adverse cardiac events in patients with ACS and may be clinically useful in the triage and management of these patients.