Atherosclerosis-associated MARCO and APOE Gene Expression, PTX3, Lp-PLA2, and KIM-1 Biomarkers in Pre- and Post-Catheterization Patients

Abstract

     Atherosclerosis (AS) is a chronic inflammatory disorder causing cardiovascular illnesses, responsible for rising death rates worldwide. This study aimed to investigate the diagnostic potential of Pentraxin 3 (PTX3), Lipoprotein-associated phospholipase A2 (Lp-PLA2), and Kidney Injury Molecule-1 (KIM-1) biomarkers, alongside MARCO and APOE gene expression. In this study, 90 participants were enrolled, aged 20 to 75, including 60 AS patients divided into two groups: 30 pre-catheterization (Pre-Cath) and 30 post-catheterization (Post-Cath) patients, along with 30 healthy controls. Results indicated markedly increased levels of PTX3, Lp-PLA2, and KIM-1 in AS patients compared to controls. Gene expression analysis using RT-qPCR showed a significant upregulation of MARCO in Pre-Cath patients. In contrast, APOE expression was notably increased in the Post-Cath patient. The higher the waist-to-hip ratio (WHR), the more significantly correlated with increased levels of Lp-PLA2, reinforcing the association between central obesity and vascular inflammation. Notably, KIM-1 levels were higher in patients with a WHR > 0.9, emphasizing its role in endothelial dysfunction in obese individuals. Correlation analysis demonstrated that there were many correlations between the parameters, such as association between KIM-1 and Age, highlighting their role in vascular inflammation. Higher PTX3 levels were observed in patients (≤50 years), particularly in the Post-Cath patient group. In contrast, KIM-1 levels were markedly higher in patients (>50 years), particularly in Pre-Cath cases, highlighting its relevance linking aging to sustained inflammation. In conclusion, this is the first Iraqi study to investigate these biomarkers and their relationship to AS, which is crucial for diagnosing, monitoring the onset, and assessing the progression of AS, and may aid in developing early diagnostic and therapeutic approaches to prevent its progression.