TNF-α and E-Selectin as Valuable Biomarkers in Patients with Acute Coronary Artery Syndrome.

Coronary artery disease (CAD) remains the leading cause of mortality worldwide, especially in developing countries, with dyslipidemia being a major risk factor. This study aimed to evaluate lipid parameters and inflammatory biomarkers-E-selectin and tumor necrosis factor-alpha (TNF-α)-to understand their roles in the pathogenesis of acute coronary syndrome (ACS). A case-control design was used, involving 120 participants: 60 patients diagnosed with ACS and 60 healthy controls, enrolled between January and December 2024. Blood samples were analyzed to assess lipid profiles, including total cholesterol, triglycerides, HDL, LDL, and VLDL, using a SMART-120 chemistry analyzer. Serum levels of TNF-α and E-selectin were measured using enzyme-linked immunosorbent assay (ELISA). Results showed significant differences in lipid profiles between ACS patients and controls, supporting the impact of dyslipidemia on ACS development. E-selectin levels were significantly elevated in ACS patients (213.26 ± 2.72 pg/mL) compared to controls (175.11 ± 2.71 pg/mL), with P < 0.0001. Similarly, TNF-α levels were higher in patients (83.20 ± 3.88 pg/mL) than controls (45.65 ± 1.79 pg/mL), also with P < 0.0001. ROC curve analysis demonstrated that E-selectin had 96% sensitivity and specificity at a cutoff of 73.44 pg/mL, while TNF-α had 93% sensitivity and 86% specificity at a cutoff of 188.65 pg/mL. Both biomarkers positively correlated with body mass index (r = 0.572, P < 0.0001).The findings suggest that TNF-α and E-selectin are potential diagnostic biomarkers for ACS and play key