CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 2, May/June 2023 106 AFRICA plasma sLOX-1 were notably up-regulated in both genders with stable and unstable CAD, compared with the healthy male and female participants (p < 0.001). However, within the male and female stable and unstable CAD subjects, the difference was not significant (Fig. 1B). Levels of plasma sLOX-1 in the 61- to 84-year healthy female subjects were significantly higher compared with the 30- to 60-year healthy females, and the 30- to 60-year and 61- to 84-year healthy male subjects (p < 0.001) (Fig. 2A). In the 61- to 84-year female stable CAD patients, plasma sLOX-1 expression was clearly up-regulated more than in the 30- to 60-year female stable CAD patients, and 30- to 60-year and 61- to 84-year male stable CAD subjects (p < 0.001) (Fig. 2B). Circulating concentrations of sLOX-1 in the female 61- to 84-year unstable CAD group were clearly increased compared to the 30- to 60-year female, and the 30- to 60-year male and 61- to 84-year male unstable CAD groups (p < 0.001) (Fig. 2C). The diagnostic efficacy of elevated circulatory sLOX-1 levels as an innovative clinical marker for stable and unstable CAD patients was determined through the ROC curve. The area under the curve (AUC) for circulating sLOX-1 between the stable CAD patients and healthy subjects was 0.895 (Fig. 3A), and the AUC for the healthy subjects and unstable CAD patients was 0.902 (Fig. 3B). This indicates that the AUC was highly specific and clearly differentiated stable and unstable CAD patients from the healthy subjects (p < 0.001). Moreover, the plasma sLOX-1 level AUC for stable and unstable CAD subjects (0.867) was also significantly different, indicating its sensitivity (Fig. 3C). The AUC, positive and negative predictive values, sensitivity, specificity, confidence interval, cut-off point and p-values are presented in Table 2. These findings indicate that up-regulated plasma circulating sLOX-1 level can be considered as a novel biochemical diagnostic marker for identification of stable and unstable CAD in patients. Circulating sLOX-1 levels 600 400 200 0 ** ## Healthy subjects Stable CAD Unstable CAD Circulating sLOX-1 levels in MIF 600 400 200 0 ** ## ## ** Male healthy subjects Female healthy subjects Male stable CAD Female stable CAD Male unstable CAD Female unstable CAD Fig. 1. A: Plasma sLOX-1 levels in healthy individuals versus stable and unstable CAD patients (p < 0.001). B: Comparison between healthy subjects and male and female patients with CAD (p < 0.001). Circulating sLOX-1 levels in healthy volunteers 150 100 50 0 ** Male (30–60 yrs) Male (61–84 yrs) Female (30–60 yrs) Female (61–84 yrs) Circulating sLOX-1 levels in stable CAD 500 400 300 200 100 0 ** Male (30–60 yrs) Male (61–84 yrs) Female (30–60 yrs) Female (61–84 yrs) Circulating sLOX-1 levels in unstable CAD 600 400 200 0 ** Male (30–60 yrs) Male (61–84 yrs) Female (30–60 yrs) Female (61–84 yrs) Fig. 2. A: Circulating plasma sLOX-1 levels in 30- to 60-year and 61- to 84-year male patients versus female healthy subjects (p < 0.001). B: Plasma sLOX-1 levels in male and female stable CAD patients (30–60 and 61–84 years) (p < 0.001). C: Plasma sLOX-1 concentrations in male and female unstable CAD patients (30–60 and 61–84 years) (p < 0.001). A A B C B
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