Submit Manuscript | http://medcraveonline.com Abbreviations: AMI, acute myocardial infarction; MI, myo- cardial infarction; CK, creatine kinase; ALT, aspartate aminotransfe- rase; CVD, cardiovascular diseases; AIP, atherogenic index of plas- ma; CRI-I, castelli’s risk index; AC, atherogenic coeffcient Introduction Myocardial Infarction (MI) is a term which is used for defning the necrosis in the heart muscle due to the lack of the oxygen need of myocardium which cannot be supplied by the coronaries. It is characterized by chest pains or discomfort which may travel into the shoulder, arm, back, neck or jaw. 1,2 Acute myocardial infarction (AMI) is considered more appropriately part of a spectrum referred to as acute coronary syndromes, which also includes unstable angina and non-ST-elevation. Patients with ischemic discomfort may or may not have ST-segment elevation. Most of those with ST-segment elevation will develop Q waves. Those without ST elevations will ultimately be diagnosed with unstable angina based on the presence of cardiac enzymes. Approximately 90% of myocardial infarction results from an acute thrombus that obstructs an atherosclerotic coronary artery. 3 The highest risk of fatality occurs within the initial hours of onset of AMI. Thus, early diagnosis of cardiac ischemia is critical for the effective management of patients with AMI. Improper diagnosis of patients with chest pain often leads to inappropriate admission of patients without AMI and vice versa. In addition to clinical history, physical examination, accurate electrocardiogram fndings and assessment of cardiac biomarkers have an important role in the early diagnosis of acute ischemia. The analysis of cardiac biomarkers has become the frontline diagnostic tools for AMI, and has greatly enabled the clinicians in the rapid diagnosis and prompt treatment planning, thereby reducing the mortality rate to a great extent. 4 There are some cardiac markers that can be used in the diagnosis of myocardial infarction among them include, aspartate transaminase, alanine transaminase, troponin I, creatine kinase, etc. Creatine kinase (isoenzymes CK-MB) is the enzyme used as a defnitive serum marker for the diagnosis or exclusion of acute myocardial infarction. 2,5 Lactate dehydrogenase, creatine kinase and their isoenzymes exhibited better cardiac specifcity. After the discovery that cardiac troponins I and T have the desired specifcity, they have replaced the cytosolic enzymes in the role of diagnosing myocardial ischemia and infarction. The use of the troponins provided new knowledge that led to revision and redefnition of ischemic myocardial injury as well as the introduction of biochemicals for estimation of the probability of future ischemic myocardial events. These markers, known as cardiac risk markers, evolved from the diagnostic markers such as CK-MB or troponins, but markers of infammation also belong to these groups of diagnostic chemicals. 6 The markers that are well suited for the early diagnosis of AMI within the time interval 0-6 hours after symptom onset are myoglobin, H-FABP and CK-MB isoforms. CK-MB mass measurement is suitable in the 6-24 hours interval; CK-MB based on activity measurement is more sensitive in the 12-24 hours interval, and the other cardiac markers like total CK, cTnT, and cTnI are most reliable after 12 hours from symptom onset. The prolonged diagnostic window of cardiac troponins of several days that is highly sensitive and specifc obviates the needs for less specifc markers with long diagnostic window like aspartate aminotransferase (ALT) and CK. Based on the recent recommendations by the ESC/ACC, cTnI and cTnT are the best markers for the confrmation of AMI. CK-MB is the second best marker in the absence of troponins assays. 7 J Appl Biotechnol Bioeng. 2017;3(4):385‒391. 385 © 2017 Azab et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Acute myocardial infarction risk factors and correlation of its markers with serum lipids Volume 3 Issue 4 - 2017 Azab Elsayed Azab, 1 Ata Sedik Ibrahim Elsayed 2 1 Department of Zoology, Alejelat, Zawia University, Libya 2 Department of Biomedical Sciences, Dar Al Uloom University, Saudi Arabia Correspondence: Azab Elsayed Azab, Department of Zoology, Faculty of Science, Alejelat, Zawia University, Libya, Email azabelsaied@yahoo.com Received: May 30, 2017 | Published: July 14, 2017 Abstract Myocardial infarction is a term applied to myocardial necrosis secondary to an acute interruption of the coronary blood supply. Atherosclerosis is by far the most common cause of myocardial infarction. According to the INTERHEART study report, nine factors are responsible for 90% of myocardial infarctions. Modifiable risk factors include Diabetes mellitus, smoking, hypertension, hyperlipidemia, sedentary life style, obesity, stress and depression. The combination of several risk factors further enhances the risk. This study aimed to evaluate the frequency of risk factors among AMI patients in Tajoura National Heart Center, Libya, and to detect the presence of correlation between AMI markers and serum lipids. This study was conducted from September, 2007 to April, 2008. On 120 acute myocardial infarction patients, 86 males and 34 females, and the results were compared to the results of 40 healthy persons (20 male and 20 female) with matched ages with the patients. The results of this study concluded that, ages of most male patients were from 45-65 years old, but most of female ages from 55-75 years old which means that, the incidence of AMI was occurred in males earlier than females. The most prevalent risk factor in male and female patients is diabetes. Smoking is the second risk factor in males, and hypertriglyceridemia was the second risk factor among female patients. The study was also showed correlation between total CK and CK-MB and total cholesterol concentration, but this was not found between LDH, TN-t and cholesterol, on the other hand, LDH was correlated with HDLC. Keywords: risk factors, lipids, HDLC, hyperlipidemia, LDH, CK-MB Journal of Applied Biotechnology & Bioengineering Research Article Open Access