SUMMARY

Acute coronary syndrome (ACS) refers to several diseases connected to an abrupt decrease in blood flow to the heart. A lack of oxygen may cause the cardiac muscle cell to die. A heart attack is the outcome of cell death that harms the muscle tissues, known as myocardial infarction (MI). Heart muscles don’t function as they should even when there isn’t cell mortality because of the drop in oxygen levels. This change may be temporary or permanent. Unstable angina is the term used when severe coronary syndrome does not result in cell death. The current study’s aim is first to see if the presence of ACS is associated with single nucleotide polymorphisms (SNPs) in the Paraoxonase-1 (PON1) and Apolipoprotein E (APOE) genes. Second, measuring some chemical biomarkers to see if there is any association between them with the ACS in an Iraqi Kurdish population.

Patients with first ACS were compared to those who initially presented with stable exertional angina, and two (SNPs) in the genes APOE and PON 1 were genotyped

A total of 77 samples were enrolled, including 61 patients with ACS and 16 controls with chest pain syndrome. The PCR assay was used to genotype the PON1 and APOE genes. Numerous statistical analyses were conducted to look at the relationship between ACS susceptibility and the SNPs in the PON 1 and APOE genes. The findings showed that there was no correlation between APOE and ACS, APOE2 (P = 0.585) was present in all patients and controls, except for two patients and one control who had APOE3 (P = 0.508). The risk factor for ACS in APOE3 showed that the AA genotype (OR=1.199, P=0.781) was a notable risk factor for the disease, but there was no statistically significant difference between the ACS and control groups. However, the TT genotype (OR=0.2532, P=0.127) demonstrated that it is not a risk factor for the condition, and there was no difference between the two groups that could be considered significant. The major ACS risk factor identified was the AT genotype (OR=2.385, P=0.2116), although there was a non-significant difference between the ACS and control groups. Additionally, in chemical biomarkers, we concluded that GOT, GPT, and troponin are statistically significant between ACS and the control group.

The current study’s findings suggest that AA and AT alleles in PON 1
 play a role in the pathogenesis of ACS, however APOE does not have association with ACS in the Kurdistan/Erbil population. Also GOT, GPT and Troponin have statistically significant difference between both patients and control. which can be used as an indicator for ACS. Even so, further research and study are recommended.