Hematological and biochemical biomarkers for diagnostic approaches to patients who apply to emergency service with chest pain

SUMMARY INTRODUCTION AND PURPOSE: Acute coronary syndrome can be described as a fatal disease which includes STEMI, NSTEMI and USAP that occurs a result of decreasing myocardial blood flowing depending on destabilization of aterosklerotic plaque. Even if the frequency of this disease decreased recently in developed countries, it is one of the primary and major reason of death all around the world. According to previous studies, it is showed that he beginning of the aterosklerotic proces and also importance of inflammation play a big role in this case. It is necessary to examine electrocardiographic findings, biochemical markers with clinical properties in a comprehensive manner, during the process of diagnosis and classification of acute coronary syndrome. In our study, we aimed to evaluate the roles of biochemical markers and also various inflammatory markers which is is being investigated in a diagnostic and prognostic respect in recent years. MATERIALS AND METHOD: This study is conducted at T.C Ministry of Health Sakarya University Emergency service between dates 01.06.2016 and 30.09.2016 with 257 patient who came with a chest pain and get diagnosed by AKS. During the study, file records are examined retrospectively. First laboratory data during application (urea, creatinine, AST, ALT, WBC, neutrophil, lymphocyte, thrombocyte, hemoglobin; hematocrit, MPV, RDW, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, platelet/neutrophil ratio, troponin and CK-MB parameters) are analyzed. FINDINGS: In the experimental group there was 257 patient (121 STEMI, 69 NSTEMI, 67 USAP) and in the control group there was 70 patient who came to emergency with a flank pain but discharged due to atypical flank pain. Sample contains 191 males and 66 females with a mean age 59,75. It is determined that all examined biochemical markers in experimental group are significantly higher, lymphocyte and PNR results are significantly lower then the control group. The increase in the WBC, neutrophil, NLR and PLR is more prominent in STEMI patients. The decrease in the PNR value and the increase in the RDW value is more specific to the NSTEMI patients. The decrease in the lymphocyte, thrombocyte and P-MPVR values are more prominent in the USAP patients. Furthermore, blood platelet count of STEMI patients is higher then USAP patients. RESULTS: Examined blood WBC, neutrophil, RDW, NLR and PLR values, taken from acute coronary syndrome patients, are significantly increases. In contrast, lymphocyte and PNR values are significantly decreases. KEY WORDS: acute myocardial infarction, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, hs-troponin, st ascendant myocardial infarction, st without ascendant infarction, unstable anjina