Burak Altun

Objective: Heart type fatty acid binding protein (H-FABP) is a low moleculer weight major cytoplasmic protein and released quickly from cardiomyocytes in response to myocardial injury. We searched functionality of H-FABP in diagnosis of acute coronary syndrome (ACS) and prevalence of coronary artery disease, relationship with its severity and early diagnosis.Materials and Methods: This was a prospective observational study. We took in 110 patients- aged 18 and above-diagnosed ACS between the dates February 2016 and January 2017. The patient population was divided into two groups as ST segment elevation ACS (STEMI, 52 patients) and Non-ST segment elevation ACS (NSTE-ACS, 58 patients). For H-FABP and cardiac troponin I (cTnI) blood samples of the patients were taken both when they first applied to the hospital and six hours later. Coronary angiography was performed to all the patients. Results: On admission, it wasn’t found a statistically significant relationship in both groups, GRACE (Global Registry of Acute Coronary Events), SYNTAX (The synergy between percutaneous coronary intervention with taxus and cardiac surgery) and between Gensini Risk skores (p=0.056, p=0.791, p=0.278). The H-FABP level of blood samples looked over six hours later with GRACE and Gensini risk scores were statistically significant in the H-FABP positive group (p=0.003, p=0.011). However SYNTAX risk score in H-FABP positive group was not statistically significant (p=0.984).Conclusion: In our study, we demonstrated the relationship between H-FABP and coronary artery disease risk scores and that H-FABP can be used in the diagnosis of ACS.

Anadolu Kardiyoloji Dergisi, Anadolu Kardiyol Derg, The Anatolian Journal of Cardiology, Anatol J Cardiol, Cardiology, Cardiovascular Medicine, Surgery, Pediatric Cardiology, Angiology

Fragmented QRS (fQRS) as a predictor of cardiac events in coronary artery disease has previously been reported. In this study, we hypothesized that presence of fQRS on a 12-lead electrocardiogram (ECG) on admission would be predictive of adverse outcomes in non-ST elevated myocardial infarction (NSTEMI). A total of 149 NSTEMI patients (112 male, 37 female) were retrospectively analyzed. The fQRS pattern was defined as the presence of an additional R', notching in the nadir of the S wave, fragmentation of the RS or QS complexes in 2 contiguous leads corresponding to a major coronary artery territory. The relationship between presence of fQRS on admission on a 12-lead ECG, and primary end points [cardiovascular death (CVD)] and secondary end points (re-infarction, repeat target vessel revascularization [percutaneous/surgical]) were assessed. The median follow-up time was 18 (13-24) months. Other than age, there were no significant differences in baseline characteristics and laboratory findings for patients in the fQRS and non-fQRS groups. The patients in the fQRS group were older [64 years vs 59 years, p=0.048]. CVD and re-infarction were significantly higher in the fQRS group in the median 18-month follow-up (26.1% vs 8.7%, p=0.005; 23.9% vs 10.7%, p=0.035, respectively). By a multivariate regression analysis in all 149 patients, age ≥65 years and the presence of fQRS in a 12-lead ECG on admission were found to be powerful independent predictors of cardiovascular mortality (HR: 4.91, 95% CI: 1.60-15.03, p=0.005; HR: 2.77, 95% CI: 1.02-7.50, p=0.044, respectively). Presence of fQRS on a 12-lead ECG on admission is associated with increased long-term mortality in patients with NSTEMI.