EARLY KINETIC CHANGES IN CARDIAC BIOMARKERS (TROPONIN-T AND CK-MB), OXIDATIVE STRESS BIOMARKERS (MDA AND SOD), AND LIPID BIOMARKERS IN ACUTE MYOCARDIAL INFARCTION: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Acute myocardial infarction (AMI) is a leading cause of mortality worldwide. Early diagnosis and prognostic assessment are essential for reducing complications and improving clinical outcomes. Along with conventional cardiac biomarkers, oxidative stress markers and lipid profile parameters may provide additional information regarding myocardial injury and recovery.

Aim: To evaluate the early kinetic changes in cardiac biomarkers, oxidative stress markers, and lipid profile parameters in patients with acute myocardial infarction during the first 12 hours after hospital admission.

Materials and Methods: This prospective observational study was conducted in the Department of Biochemistry in collaboration with the Departments of Cardiology and Emergency Medicine at MGM Medical College and Hospital, Navi Mumbai, from August 2024 to April 2026. A total of 92 patients diagnosed with acute myocardial infarction were enrolled. Blood samples were collected at admission (0 hour) and at 12 hours post-admission. Serum Troponin-T and CK-MB were estimated using electrochemiluminescence and enzymatic kinetic methods, respectively. Malondialdehyde (MDA) levels were determined by the Kei Satoh method, while Superoxide Dismutase (SOD) activity was measured using the Marklund and Marklund method. Lipid profile parameters were analyzed using standard enzymatic methods: total cholesterol by the CHOD-PAP method, triglycerides by the GPO-Trinder method, and HDL-cholesterol by the phosphotungstic acid method. LDL-cholesterol and VLDL-cholesterol were calculated using Friedewald’s formula. Statistical analysis was performed using paired t-test, and p < 0.05 was considered statistically significant.

Results: Troponin-T and CK-MB levels showed a highly significant increase at 12 hours post-admission compared with baseline values (p < 0.0001). MDA levels significantly decreased, whereas SOD activity significantly increased at 12 hours (p < 0.0001), indicating modulation of oxidative stress and antioxidant defense mechanisms following myocardial injury. Lipid profile parameters, including total cholesterol, triglycerides, HDL, LDL, and VLDL, did not show statistically significant changes during the first 12 hours (p > 0.05). Conclusion: Cardiac biomarkers demonstrated significant early elevation in AMI patients, confirming their diagnostic utility in myocardial injury. The reduction in MDA levels along with increased SOD activity reflects early recovery of antioxidant defense mechanisms. The lipid profile remained relatively stable during the initial 12-hour period, supporting the usefulness of early lipid assessment in AMI patients. A combined multi-biomarker approach may enhance early diagnosis, prognostic evaluation, and therapeutic management of acute myocardial infarction.