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Abstract Coronary artery disease (CAD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart. Coronary artery disease (CAD) is the leading cause of death worldwide. It is noted that the symptoms and signs of coronary artery disease appear in the advanced state of disease, most individuals with coronary artery disease show no evidence of disease for decades as the disease progresses before the first onset of symptoms, in form of sudden heart attack. Omentin-1 (Intelectin-1) is a newly identified protein that is highly and selectively expressed in visceral adipose tissue. Omentin-1 may act as an endocrine factor affecting muscles, liver and omental adipose depot to enhance insulin-mediated glucose-uptake in adipocytes, activate protein kinase Akt/PKB, and improve the insulin sensitivity of fat cells. Interestingly, circulating omentin-1 levels have been negatively correlated with obesity and insulin resistance. Omentin plays an anti-inflammatory role by preventing the TNFα-induced COX-2 expression in vascular endothelial cells. The plasma levels of omentin were decreased in patients with coronary artery disease (CAD), which indicated that omentin-1 may also be involved in the occurrence of coronary artery disease. Summary 80 Omentin inhibits TNF-α-induced inflammation of intravascular Smooth Muscle Cells (SMCs), and its anti-inflammatory role is attributed, at least in part, to the inhibition of superoxide production. Omentin has two isoforms: omentin-1 and omentin-2; omentin-1 was shown to be the major circulating isoform in human plasma. In addition, omentin-1 was also regarded as a protective cytokine in the metabolic imbalance condition of the body. Therefore, decreased levels of omentin-1 may be involved in the occurrence and development of coronary artery disease (CAD). This study aimed to assess the role of plasma levels of omentin-1 in elderly patients with coronary artery disease. This study included 90 participants; divided into three groups: group I 30 stable angina pectoris cases, group II 30 acute coronary syndrome cases and group III (control group) 30 volunteers from the general population matched for age and sex without evidence of any coronary artery disease neither by history nor by investigations. There were no statistically significant differences between the studied groups as regarding age and sex distribution. However, there was significant difference between groups as regarding body mass index (BMI) with significant difference between control group and both the stable angina, acute coronary syndrome groups & non-significant difference between stable angina and acute coronary syndrome group. Among ACS groups there were no statistically significant differences between the 3 groups as regarding age, BMI and sex distribution. Summary 81 Also in our study, there was highly statistically significant difference between studied groups as regarding occurrence of diabetes mellitus and hypertension. It showed that 73.3 % of acute coronary syndrome patients were diabetic compared to 66.7% among stable angina group and both groups showed equal frequency in occurrence of hypertension. Among ACS groups there were no significant difference between the 3 groups as regarding occurrence of diabetes mellitus and hypertension. There was highly statistical significant difference between studied groups as regarding total cholesterol and LDL-C while there was significant difference between them as regarding triglycerides and HDL-C. There was significant difference between control & acute coronary syndrome groups, also between stable angina & acute coronary syndrome groups in total cholesterol and HDL -C, but there was no significant difference in both of them among control & stable angina groups (P>0.05). Also, there was significant difference between control and the other 2 groups as regarding triglycerides. Among ACS groups there were no significant differences among the 3 groups as regarding levels of total cholesterol, triglycerides , HDL-C and LDL-C. In our study, there was highly statistical significant difference between the studied groups as regarding AST, but the difference was non-significant among groups in ALT. There was significant difference between stable angina & acute coronary syndrome groups in ALT. Also, there was significant difference between control & acute coronary syndrome groups, & stable angina in AST. Among ACS groups there Summary 82 were no significant differences among the 3 groups as regarding levels of ALT and AST. Also, there was significant difference between the studied groups as regarding hsCRP, but the difference was non-significant among groups in creatinine level and urea level. There was highly statistical significant difference between ACS groups as regarding hsCRP. It was noticed that there was significant difference between unstable angina group, STEMI & non STEMI groups but there was no difference between STEMI and non STEMI groups. There were no significant differences between the ACS groups as regarding Urea and Creatinine levels. Our study showed that there was statistically significant difference between studied groups as regarding Omentin-1 level. Also, there were significant decrease in its level in stable angina group and acute coronary syndrome groups compared to control group , yet there was no difference between stable angina versus acute coronary syndrome groups. Among ACS groups there were no significant differences as regarding Omentin-1 levels. In our study, there was non-significant negative correlation between Omentin-1 level and body mass index, total cholesterol , LDLC, urea, creatinine and AST, and non-significant positive correlation between omentin-1 and HDL-C and ALT. There was significant positive correlation between Omentin-1 level and triglycerides. But, there was highly statistical significant negative correlation between Omentin-1 level and hsCRP. Among acute coronary syndrome‟s Summary 83 groups, there was non-significant negative correlation between Omentin-1 level and body mass index, total cholesterol, LDL-C, urea, creatinine, AST. There was non-significant positive correlation between Omentin-1 level and triglycerides, HDL-C, hsCRP & ALT. Our study found that at cut off ≤ 9 .5 ng / L omentin-1 has 83.3% sensitivity and 71.7% specificity with 59.5% PPV and 89.6% NPV with 75.6% accuracy. So, we can consider that omentin-1 may be involved in CAD and can be used as abiomarker for its occurance |