Emerging Therapeutic Targets for Acute Coronary Syndromes: Novel Advancements and Future Directions

Elevated serum asprosin and ANGPTL8 gene expression as novel biomarkers for the diagnosis and prognosis of acute coronary syndrome

Introduction

Managing acute coronary syndrome (ACS) remains a major global healthcare concern. Identifying novel biomarkers is crucial to improving early detection and patient classification. Traditional markers such as cardiac troponins have limitations, including delayed detectability in blood samples, necessitating the search for better alternatives. Asprosin and angiopoietin-like protein 8 (ANGPTL8) have recently emerged as potential biomarkers for ACS diagnosis.

Methods

This comparative study included 100 participants, equally divided into ACS patients and healthy controls with matched demographics. Enzyme-linked immunosorbent assay (ELISA) was employed to quantify asprosin concentrations, while real-time polymerase chain reaction (RT-PCR) assessed ANGPTL8 gene expression levels. Receiver operating characteristic (ROC) curve analysis evaluated the diagnostic utility of these biomarkers, and Spearman's correlation was used to examine relationships between variables.

Results

Asprosin levels were significantly elevated in ACS patients (5.27 ± 0.67 ng/ml) compared to healthy individuals (3.82 ± 1.20 ng/ml, P < 0.001). ROC analysis demonstrated high diagnostic performance, with an area under the curve (AUC) of 0.95, 94% detection accuracy, and 85% precision in true negative identification. Similarly, ANGPTL8 expression was markedly increased (P < 0.001), showing an AUC of 0.83, 88% detection accuracy, and 64% specificity. A strong positive correlation was observed between asprosin and ANGPTL8 (r = 0.795, P < 0.0001).

Discussion

The findings highlight the potential of asprosin and ANGPTL8 as promising diagnostic and prognostic markers for ACS. Their high sensitivity and correlation suggest a complementary role in early ACS detection. However, further clinical trials are required to validate these biomarkers in broader patient populations and determine their practical implementation in medical settings.

Conclusion

Asprosin and ANGPTL8 exhibit strong diagnostic potential in ACS detection, potentially improving early intervention strategies. Future studies should focus on their integration into clinical practice for enhanced patient outcomes.

Mental Illness Strikes at the Heart: Impact of Psychiatric Diseases on Ventricular Ejection Fraction in Patients with Acute Coronary Syndromes

Mental illnesses can have a significant impact on individuals experiencing acute coronary syndromes (ACS). Mental illnesses are associated with an increased cardiovascular risk profile and early onset of cardiovascular disease. A critical aspect of this interplay is the effect of psychiatric conditions on left ventricular ejection fraction (LVEF), a key parameter in evaluating cardiac function and predicting long-term outcomes in ACS patients. The present single-center, retrospective study investigated the associations between psychiatric conditions and cardiac function, with a focus on LVEF in ACS patients. The inclusion criteria were Italian nationality and 30 years or older. One hundred and sixty-four patients without (Mage = 68.8 ± 10.6, 62 females) and 161 patients with a psychiatric diagnosis (Mage = 68.4 ± 13.7, 63 females) were enrolled. The data collected included sociodemographic variables, psychiatric diagnoses, LVEF, ACS type (STEMI/NSTEMI), smoking status, previous interventions, and pharmacological treatments. Statistical analyses included chi-square, t-tests, ANOVAs, and ANCOVA to assess differences across groups. Findings revealed lower LVEF in patients with a psychiatric diagnosis compared to patients without a psychiatric diagnosis (p = 0.004, d = 0.36). Patients without a psychiatric diagnosis were associated with NSTEMI (p = 0.047, φ = 0.11), hypertension (p = 0.003, φ = -0.16), and dyslipidemia (p = 0.022, φ = -0.13). In contrast, patients with a psychiatric diagnosis were associated with STEMI (p = 0.047, φ = 0.11), neurological dysfunction (p = 0.014, φ = 0.14), and chronic obstructive pulmonary disease (p = 0.010, φ = 0.14). Among psychiatric diagnoses, anxiety disorders were associated with lower LVEF compared to substance abuse disorders (p = 0.012, d = -0.81). The findings underscore the complex relationship between mental illness and cardiac function, emphasising the need to integrate psychiatric evaluations into cardiology care to optimise the management of both mental and cardiovascular health. This study has several limitations, including its design, which prevents causal conclusions, and the use of convenience sampling, which limits the generalizability of the findings.

From Cells to Plaques: The Molecular Pathways of Coronary Artery Calcification and Disease

Coronary artery calcification (CAC) is a hallmark of atherosclerosis and a critical factor in the development and progression of coronary artery disease (CAD). This review aims to address the complex pathophysiological mechanisms underlying CAC and its relationship with CAD. We examine the cellular and molecular processes that drive the formation of calcified plaques, highlighting the roles of inflammation, lipid accumulation, and smooth muscle cell proliferation. Additionally, we explore the genetic and environmental factors that contribute to the heterogeneity in CAC and CAD presentation among individuals. Understanding these intricate mechanisms is essential for developing targeted therapeutic strategies and improving diagnostic accuracy. By integrating current research findings, this review provides a comprehensive overview of the pathways linking CAC to CAD, offering insights into potential interventions to mitigate the burden of these interrelated conditions.

Chemerin in the Spotlight: Revealing Its Multifaceted Role in Acute Myocardial Infarction

Chemerin, an adipokine known for its role in adipogenesis and inflammation, has emerged as a significant biomarker in cardiovascular diseases, including acute myocardial infarction (AMI). Recent studies have highlighted chemerin's involvement in the pathophysiological processes of coronary artery disease (CAD), where it modulates inflammatory responses, endothelial function, and vascular remodelling. Elevated levels of chemerin have been associated with adverse cardiovascular outcomes, including increased myocardial injury, left ventricular dysfunction, and heightened inflammatory states post-AMI. This manuscript aims to provide a comprehensive review of the current understanding of chemerin's role in AMI, detailing its molecular mechanisms, clinical implications, and potential as a biomarker for diagnosis and prognosis. Additionally, we explore the therapeutic prospects of targeting chemerin pathways to mitigate myocardial damage and improve clinical outcomes in AMI patients. By synthesizing the latest research findings, this review seeks to elucidate the multifaceted role of chemerin in AMI and its promise as a target for innovative therapeutic strategies.