Evaluating 13-HODE and 15-LOX as novel lipid-derived biomarkers in acute coronary syndrome: Insights from Iraqi patients

<b>Background and objective:</b> 13-HODE, a bioactive lipid derivative of linoleic acid, has emerged as a significant mediator in acute coronary syndrome (ACS), influencing inflammation and vascular function. Arachidonate 15-lipoxygenase (15-LOX) plays a crucial role in ACS by modulating inflammatory processes and influencing lipid metabolism within cardiovascular tissues. This study aims to assess the concentrations of 13-HODE and 15-LOX and their potential role as predictive biomarkers in ACS patients.<br /> <b>Methods and materials:</b> The study enrolled 90 ACS patients and 90 controls aged 30–70. Blood samples were analyzed for biomarkers (troponin [Tp], creatine kinase MB [CK-MB], high-sensitivity C-reactive protein [hs-CRP], lipid profile, 13-HODE, and 15-LOX) via ELISA and Ichroma device in addition to measurement of HbA1c%. Data were statistically analyzed using SPSS, ANOVA, and ROC tests and correlation coefficient.<br /> <b>Results:</b> This study examined 13-HODE and 15-LOX levels in 90 ACS patients and 90 controls, finding significantly higher levels in ACS patients (p < 0.0001 and p = 0.015, respectively). 13-HODE demonstrated strong diagnostic potential (area under the curve [AUC] 0.735, sensitivity 70%, specificity 71.9%), while 15-LOX showed a moderate value (AUC 0.622). CK-MB, hs-CRP, and Tp exhibited superior diagnostic accuracy (e.g., CK-MB AUC 0.963). 13-HODE correlated negatively with HbA1c, and 15-LOX linked negatively with LDL and cholesterol, highlighting their roles in lipid metabolism and atherosclerosis, and supporting their utility as complementary ACS biomarkers.<br /> <b>Conclusions: </b>The study found that 13-HODE and 15-LOX differ significantly between ACS patients and controls, with 13-HODE showing stronger diagnostic potential. CK-MB, hs-CRP, and Tp exhibited high diagnostic utility, while 15-LOX correlates with lipid oxidation and atherosclerosis.