الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 123 |  |  |
| | | from | 123 | | |
Abstract
Death from coronary artery disease is by far the leading cause of death worldwide. There is no doubt that a better understanding of atherothrombosis has guided development of improved diagnostic facilities as well as revascularization technologies in combination with current antithrombotic strategies that have altogether impressively reduced acute thromboembolic complications and death from cardiovascular causes within the last decades. However, the rate of ischemic complications even after optimal revascularization and medical therapy remains high.
Similarly, morbidity and death associated with chronic ischemic heart disease and ischemic cardiomyopathy respectively are constantly rising. Therefore, there is still a strong need for effective primary prevention strategies, fast and accurate diagnostic procedures as well as for new and smart antithrombotic drugs. The review focuses on ACS which is one of the common problems we face in our career; intensive care medicine, appropriate early intervention in patients with ACS can save lives. This survival benefits, however, is time-dependant, and steadily declines in the hours that follow the first signs of ischemic injury. This is the famous time is muscle axiom that drives the early management of ACS, Worse prognostic information of ACS can be obtained from routine hematologic tests such as CBC through the important role of blood elements of the pathogenesis of ACS.
Elevations in WBC count have been associated with the development of acute myocardial infarction (AMI) and with long-term mortality in patients with coronary artery disease. Anemia has been shown to be present in ≈15% of patients presenting with acute myocardial infarction (MI) and in 43% of elderly patients with acute MI. Platelets play role in the pathogenesis of cardiovascular disorders, including atherosclerosis and its complications, such as unstable angina (UA) and myocardial infarction (MI).
Thrombus is major cause of acute coronary syndromes (ACS) and platelets play an important role in developing intravascular thrombus; the central role of platelet activation has long been noticed in this pathophysiology; hence, many therapies have been directed against it. The review focuses also on Lectin-like oxidized low density lipoprotein receptor-1 (LOX-1), the main oxidized low-density lipoprotein (OxLDL) in endothelial cells, is upregulated in atherosclerotic lesions and is involved in several cellular processes that regulate the pathogenesis of atherosclerosis sLOX-1 increases in plasma or serum of patients with ACS or with CAD compared to control subjects and, when combined with other serum biomarker levels, might have the potential to increase the diagnosis accuracy of acute coronary syndromes or to predict disease progression or the risk of future cardiovascular events.
Finally I focused on cardiac (Troponins, Creatinine kinase, CKMB, Myoglobine, Brain natriuretic peptide (BNP) and High sensitivity CRP) as relevant markers of myocardial necrosis, currently used in the diagnostic process of acute coronary syndrome. Furthermore, I discussed the potential role of copeptin, a new marker of acute endogenous stress in acute coronary syndrome patients, as faster diagnosis might lead to faster treatment as well as improved short- and long-term outcome following acute coronary syndrome. Finally, I put some examples of biomarkers which have some importance in diagnosis and prognosis of ACS.