Correlation of osteopontin hormone with TIMI score and cardiac markers in patients with acute coronary syndrome presenting with chest pain.

Abstract

Aim: Rapid evaluation of patients with acute coronary syndrome (ACS) attending the emergency service under emergency room conditions and using appropriate risk scoring would improve treatment success. Calcium levels accumulate in the tissue in people with coronary artery disease and this has been found to correlate with osteopontin levels in some studies. It is predicted that osteopontin level could be used as a biomarker to detect coronary artery calcification. In this study, we aimed to evaluate the use of osteopontin levels in the differential diagnosis of ACS in conjunction with cardiac troponin I (cTnI) levels, and HEART (history, ECG, age, risk factors, troponin) and thrombolysis in myocardial infarction (TIMI) scores in patients with chest pain who attended the emergency service.

Methods: This study was conducted as a prospective observational clinical study in the Department of Emergency Medicine, Faculty of Medicine, Ataturk University. There was a total of 90 participants, including 60 patients and 30 healthy individuals in the control group. All participants' demographic information, electrocardiography (ECG) findings, cTnI level, TIMI and HEART score, and osteopontin level were evaluated.

Results: The patients' mean age was 51.61 ± 17.56 years and 63.3% (n = 57) were male. The body mass index (BMI) of the patients was 25.63 ± 4.67 kg/m². Patients with chest pain [CP(+)] and high cardiac troponin I levels [cTnl(+)] were found to be older and to have higher HEART and TIMI scores than individuals with CP(+) and normal cardiac troponin I levels [cTnl(-)] and the healthy control group (p < 0.001). While the HEART score was zero in 22 (24.4%) of the patients, the TIMI score was zero in 42 (46.7%). In terms of gender distribution, vital signs and serum osteopontin levels, there was no significant difference between the patient groups (p > 0.05). It was found that patients with CP(+) and cTnl(+) had a higher rate of ECG abnormalities than the CP(+) and cTnl (-) group and the healthy control group (p = 0.13 and p < 0.001, respectively). In 65 (72.2%) of the patients, the ECG results were normal. ST-segment elevation was detected in 13 (14.4%) patients. In our study, cTnl levels were found to be positively correlated with age (r = 0.624), BMI (r = 0.291), HEART score (r = 0.794) and TIMI score (r = 0.805) (p = 0.001, p = 0.005, p = 0.001 and p = 0.001, respectively). In our study, we discovered that osteopontin levels could not reach the differential diagnostic level for ST-elevation myocardial infarction or non-ST-elevation myocardial infarction. No statistically significant difference was found in osteopontin levels between the groups (p > 0.05).

Conclusions: While very positive results were obtained in this approach to the ACS diagnosis using HEART and TIMI scores in patients with chest pain who attended the emergency service and were diagnosed with ACS, no significant results could be obtained regarding the use of osteopontin levels as a biomarker. More comprehensive, multicentre studies involving a large number of appropriately selected patients are considered to be necessary.