Al Neama, A. (2026). Role of Cholinesterase Enzymes as Rising Biomarkers in Cardiovascular Disease Diagnosis and Prognosis. , 23(2), 45-52. doi: 10.33899/iraqij.p.2025.159681.1147
Arkam Thabit Al Neama. "Role of Cholinesterase Enzymes as Rising Biomarkers in Cardiovascular Disease Diagnosis and Prognosis". , 23, 2, 2026, 45-52. doi: 10.33899/iraqij.p.2025.159681.1147
Al Neama, A. (2026). 'Role of Cholinesterase Enzymes as Rising Biomarkers in Cardiovascular Disease Diagnosis and Prognosis', , 23(2), pp. 45-52. doi: 10.33899/iraqij.p.2025.159681.1147
Al Neama, A. Role of Cholinesterase Enzymes as Rising Biomarkers in Cardiovascular Disease Diagnosis and Prognosis. , 2026; 23(2): 45-52. doi: 10.33899/iraqij.p.2025.159681.1147

Role of Cholinesterase Enzymes as Rising Biomarkers in Cardiovascular Disease Diagnosis and Prognosis

Iraqi Journal of Pharmacy
Article 1, Volume 23, Issue 2, June 2026, Pages 45-52    PDF (647.16 K)
Document Type: Review Paper
DOI: 10.33899/iraqij.p.2025.159681.1147
Author
Arkam Thabit Al Neama*
Department of Pharmacology and Toxicology, College of Pharmacy, University of Mosul, Mosul, Iraq
Abstract
Background: Cardiovascular diseases remain the leading cause of mortality worldwide, necessitating the identification of reliable biomarkers to improve risk assessment and therapeutic strategies. Cholinesterases, particularly acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), have emerged as potential prognostic indicators due to their involvement in metabolic and inflammatory pathways linked to cardiovascular pathology. Methods: This review systematically examines recent studies evaluating the relationship between cholinesterase activity and cardiovascular diseases, including hypertension, ischemic heart disease, and heart failure. Literature sources were selected based on relevance to clinical and experimental research, focusing on the predictive value of cholinesterases for major adverse cardiovascular events (MACE). Results: Findings indicate a complex interaction, with some studies reporting an inverse correlation between cholinesterase activity and cardiovascular risks, while others associate elevated BChE levels with metabolic syndrome. Age and disease progression appear to influence this relationship, highlighting the need for further investigation. Conclusion: This review underscores the significance of cholinesterase enzymes as potential biomarkers and calls for additional research to establish their clinical utility in cardiovascular risk stratification.

Highlights
  • Cholinesterase activity may serve as a biomarker for cardiovascular risk assessment.
  • Cholinesterase levels correlate with hypertension and metabolic syndrome.
  • Lower serum cholinesterase is associated with worse outcomes in heart failure.
  • Changes in cholinesterase activity are linked to ischemic heart disease prognosis.
  • Cholinesterase could indirectly reflect parasympathetic dysfunction in heart diseases.
Keywords
Acetylcholinesterase; Butyrylcholinesterase; Heart failure; Hypertension; Ischemic heart disease
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