Prognostic Significance and Early Kinetic Changes of BNP, H-FABP, and Oxidative Stress Biomarkers (MDA and SOD) in Acute Myocardial Infarction

Abstract

Background: Acute myocardial infarction (AMI) is associated with myocardial ischemia, ventricular dysfunction, and excessive oxidative stress leading to significant cardiovascular morbidity and mortality. Early assessment of biomarkers reflecting hemodynamic stress, myocardial injury, and oxidative damage may improve prognostic evaluation and clinical management in AMI. Aim: To evaluate the early kinetic changes and prognostic significance of B-type Natriuretic Peptide (BNP), Heart-type Fatty Acid-Binding Protein (H-FABP), and oxidative stress biomarkers [Malondialdehyde (MDA) and Superoxide Dismutase (SOD)] in patients with acute myocardial infarction. 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 based on clinical findings, electrocardiographic changes, and biochemical parameters were enrolled after obtaining written informed consent. Blood samples were collected at admission (0 hour) and at 12 hours post-admission. BNP and H-FABP were estimated using the ELISA method. MDA levels were estimated by the Kei Satoh method, while SOD activity was determined by the Marklund and Marklund method. Statistical analysis was performed using paired t-test, and p < 0.05 was considered statistically significant. Results: Significant increases were observed in serum BNP and H-FABP levels at 12 hours post-admission compared to admission values (p < 0.0001). Oxidative stress biomarkers also demonstrated significant alterations, with a significant decrease in MDA levels and a significant increase in SOD activity at 12 hours post-admission compared to baseline values (p < 0.0001). Conclusion: BNP and H-FABP exhibit significant early kinetic changes and provide valuable prognostic information in acute myocardial infarction. H-FABP serves as an important ultra-early biomarker of myocardial injury, while BNP reflects ventricular stress and remodeling risk. Dynamic alterations in MDA and SOD indicate oxidative injury and endogenous antioxidant defense recovery. A combined assessment of neurohormonal and oxidative stress biomarkers may enhance prognostic evaluation and risk stratification in patients with acute myocardial infarction.