Fragmente Qrs Saptanan Akut Koroner Sendromlu Hastalarda St-2, Osteopontin Ve Miyeloperoksidaz

Abstract

Aim: In this study, we aimed to investigate the myeloperoxidase (MPO), osteopontin (OPN) and soluble ST2 (sST2) levels in acute coronary syndrome (ACS) patients with and without a fragmented QRS which is a depolarization disorder caused by myocardial fibrotic tissue on ECG, in fasting blood samples taken between 12th and 36th hours after the development of ACS. We also aimed to investigate whether these biomarkers will be useful in the diagnosis of coronary diseases. Material and Method: 60 patients who were admitted to the emergency department with chest pain and diagnosed with ACS, and 26 healthy individuals compatible with age and gender were included in the study. Patients diagnosed with ACS were divided into two groups: fQRS detected (n=30) and not fQRS detected (n=30). OPN, sST2, MPO and other biochemical and hematological parameters were measured by taking 8-hour fasting blood samples from all groups. Results: In the patient groups who diagnosed with ACS, serum MPO (33.7 U/L), OPN (103.29 ng/mL) and sST2 (495.4 pg/mL) levels were found to be significantly higher than the control group (23.14 U/L, 42.65 ng/mL, 344.11 pg/mL, respectively; p<0.01, p<0.01, p<0.05). However, there were no significant difference between MPO (32.74 U/L), OPN (101.89 ng/mL) and sST2 (451.97 pg/mL) levels of patients with (fQRS+) and without fQRS (fQRS-) (34.67 U/L, 104.69 ng/mL, 535.73 pg/mL; p>0.05). There were positive correlations between MPO and platelet (r = 0.376, p <0.05) levels in fQRS+ group, sST2 and triglyceride levels in fQRS- group, as well as sST2 and troponin-I (r=0.276; p<0.05) levels in patients diagnosed with ACS. When the diagnostic performances for ACS was examined, the sensitivity of CK-MB, troponin-I, MPO, OPN and sST2 were 83%, 80%, 65%, 85%, 58% and specificity 96%, 100%, 72%, 96%, %80, respectively. Nevertheless, these parameters were not found to have a diagnostic value for the diagnosis of fQRS (p> 0.05). Conclusions: The results of our study indicated that increased serum MPO, OPN and sST2 levels might be the associated factors that may contribute to the diagnosis and development of ACS, but the diagnostic value of these parameters in fQRS diagnosis are not significant. In addition, compared to other parameters measured, the discovery of the high diagnostic sensitivity and specificity of OPN between 12th and 36th hours following the development of ACS is a new finding obtained in this study. This study is important in that it is the first study to exhibit the relationship between MPO, OPN and sST2 and fQRS development.