1Department of Chemistry and Biochemistry, College of Medicine, Mustansiriyah University
2Department of Internal Medicine, College of Medicine, Mustansiriyah University
Acute coronary syndrome (ACS) is the major acute clinical manifestation of coronary heart disease (CHD). The term ACS includes ST-elevation myocardial infarction (STEMI), non-ST elevation (NSTEMI) and unstable angina (UA).
To measure serum levels of osteopontin (OPN), osteoprotegrin (OPG) in ACS patients with its subtyping and to study the association of their levels with extent of cardiac injury.
Patients (≥30years) were consecutively selected after have been diagnosed as STEMI (n=60), NSTEMI (n=24) and UA (n=36) depending on clinical evaluation, electrocardiography and troponin testing. Healthy (n=64), age-and sex-matched subjects were taken as controls. For each study subject, clinical characteristics were recorded and the serum OPN, OPG, and troponin I-3 (cTn-I-3) were measured.
OPN level was significantly higher in ACS patients than in controls and showed a correlation with cTn-I-3 level. There was a graded increase in its level from UA to NSTEMI and to STEMI patients. OPN had area under the curve (AUC) of 0.897, a sensitivity of 82.5%, a specificity of 99.29%, and a diagnostic accuracy of 88.34% in discrimination between ACS patients and controls. OPG was significantly higher in STEMI subgroup and in NSTEMI subgroup than in controls but not between UA and controls. Additionally, the mean level was significantly higher in STEMI than in NSTEMI subgroup and was also higher in NSTEMI than in UA but the difference did not reach statistical significance.
The study detection of significant increases in OPN and OPG levels in all or certain subtypes of ACS patients than in controls may be of value in their use as adjuvant to cTn in earlier diagnosis and management of ACS patients.
Acute coronary syndrome, Osteopontin, Osteoprotegerin, Coronary heart disease, body mass index
