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Osteopontin, Suppression of Tumorgenicity 2 and Myeloperoxidase Levels in Acute Coronary Syndrome Patients with Fragmented QRS

Yıl 2023, Cilt: 40 Sayı: 2, 225 - 231, 19.07.2023

Seda Suzan Memecan Tevfik Noyan Osman Bektaş

Öz

Background/aim: In recent years, studies have focused on new markers to predict the risk of cardiovascular diseases (CVD). There are several studies analyzing biomarkers such as myeloperoxidase (MPO), suppression of tumorgenicity 2 (sST2), and osteopontin (OPN) in CVD, however, there are no studies that show their relationship in patients who have fragmented QRS (fQRS). It was aimed to investigate the OPN, sST2, and MPO levels in patients who were diagnosed with the acute coronary syndrome (ACS) in the present study.
Materials and Methods: Sixty ACS patients and 26 healthy individuals were included in the study. Patients diagnosed ACS were divided into two groups as (+)fQRS (n=30) and (-)fQRS (n=30). Levels of OPN and sST2 were measured by ELISA, and also MPO was measured by colorimetric methods.
Results: In ACS patients, serum MPO (33.7 U/L), OPN (103.29 ng/mL) and sST2 (495.4 pg/mL) levels were found 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 differences between MPO, OPN and sST2 levels in patients with (+)fQRS (respectively, 32.74 U/L, 101.89 ng/mL and 451.97 pg/mL) and (-)fQRS (respectively, 34.67 U/L, 104.69 ng/mL, 535.73 pg/mL). There were also positive correlations between MPO and platelet (r=0.376, p<0.05) levels in the (+)fQRS group, and sST2 and triglyceride levels in the (-)fQRS group. When the diagnostic performances for ACS were 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.
Conclusions: In conclusion, MPO, OPN, and sST2 may be included in the factors that may contribute to the diagnosis and development of ACS. In addition, the discovery of the high diagnostic sensitivity and specificity of OPN in acute coronary syndrome is a new finding obtained in this study.

Anahtar Kelimeler

Acute coronary syndrome osteopontin sST2 myeleporoxidase

Destekleyen Kurum

This study was supported by Ordu University Scientific Research Projects Coordination Department

Proje Numarası

Project Number: B-1905

Teşekkür

The authors would like to thank Assistant Professor Sıddık Keskin, Van Yuzuncu Yil University, Van/ Türkiye, for helping statistical analysis.

Kaynakça

  • Take Y, Morita H. Fragmented QRS: What Is The Meaning? Indian Pacing Electrophysiol J. 2012 Sep;12(5):213-25. doi: 10.1016/s0972-6292(16)30544-7. Epub 2012 Sep 1. PMID: 23071383; PMCID: PMC3443879.
  • Pascual-Figal DA, Januzzi JL. The biology of ST2: the International ST2 Consensus Panel. Am J Cardiol. 2015 Apr 2;115(7 Suppl):3B-7B. doi: 10.1016/j.amjcard.2015.01.034. Epub 2015 Jan 23. PMID: 25665766.
  • Binas D, Daniel H, Richter A, Ruppert V, Schlüter KD, Schieffer B, Pankuweit S. The prognostic value of sST2 and galectin-3 considering different aetiologies in non-ischaemic heart failure. Open Heart. 2018 Feb 26;5(1):e000750. doi: 10.1136/openhrt-2017-000750. PMID: 29531765; PMCID: PMC5845404.
  • You H, Jiang W, Jiao M, Wang X, Jia L, You S, Li Y, Wen H, Jiang H, Yuan H, Huang J, Qiao B, Yang Y, Jin M, Wang Y, Du J. Association of Soluble ST2 Serum Levels With Outcomes in Pediatric Dilated Cardiomyopathy. Can J Cardiol. 2019 Jun;35(6):727-735. doi: 10.1016/j.cjca.2019.02.016. Epub 2019 Feb 27. PMID: 31151708.
  • Aimo A, Migliorini P, Vergaro G, Franzini M, Passino C, Maisel A, Emdin M. The IL-33/ST2 pathway, inflammation and atherosclerosis: Trigger and target? Int J Cardiol. 2018 Sep 15;267:188-192. doi: 10.1016/j.ijcard.2018.05.056. Epub 2018 May 19. PMID: 29793758.
  • Mohamadpour AH, Abdolrahmani L, Mirzaei H, Sahebkar A, Moohebati M, Ghorbani M, Ferns GA, Ghayour-Mobarhan M. Serum osteopontin concentrations in relation to coronary artery disease. Arch Med Res. 2015 Feb;46(2):112-7. doi: 10.1016/j.arcmed.2015.02.005. Epub 2015 Mar 2. PMID: 25743929.
  • Giachelli CM, Bae N, Almeida M, Denhardt DT, Alpers CE, Schwartz SM. Osteopontin is elevated during neointima formation in rat arteries and is a novel component of human atherosclerotic plaques. J Clin Invest. 1993 Oct;92(4):1686-96. doi: 10.1172/JCI116755. PMID: 8408622; PMCID: PMC288328.
  • van der Veen BS, de Winther MP, Heeringa P. Myeloperoxidase: molecular mechanisms of action and their relevance to human health and disease. Antioxid Redox Signal. 2009 Nov;11(11):2899-937. doi: 10.1089/ars.2009.2538. Erratum in: Antioxid Redox Signal. 2010 Feb;12(2):322. Augusto, Ohara [removed];Chen, John W [removed]; Davies, Michael [removed]; Ma,Xin-Liang [removed]; Malle, Ernst [removed]; Pignatelli, Pasquale [removed]; Rudolph, Tanja [removed]. PMID: 19622015.
  • Stocker R, Huang A, Jeranian E, Hou JY, Wu TT, Thomas SR, Keaney JF Jr. Hypochlorous acid impairs endothelium-derived nitric oxide bioactivity through a superoxide-dependent mechanism. Arterioscler Thromb Vasc Biol. 2004 Nov;24(11):2028-33. doi: 10.1161/01.ATV.0000143388.20994.fa. Epub 2004 Aug 26. PMID: 15331437.
  • Sugiyama S, Kugiyama K, Aikawa M, Nakamura S, Ogawa H, Libby P. Hypochlorous acid, a macrophage product, induces endothelial apoptosis and tissue factor expression: involvement of myeloperoxidase-mediated oxidant in plaque erosion and thrombogenesis. Arterioscler Thromb Vasc Biol. 2004 Jul;24(7):1309-14. doi: 10.1161/01.ATV.0000131784.50633.4f. Epub 2004 May 13. PMID: 15142860.
  • Ehrenfeld P, Matus CE, Pavicic F, Toledo C, Nualart F, Gonzalez CB, Burgos RA, Bhoola KD, Figueroa CD. Kinin B1 receptor activation turns on exocytosis of matrix metalloprotease-9 and myeloperoxidase in human neutrophils: involvement of mitogen-activated protein kinase family. J Leukoc Biol. 2009 Nov;86(5):1179-89. doi: 10.1189/jlb.0109012. Epub 2009 Jul 29. PMID: 19641039.
  • Bradley PP, Priebat DA, Christensen RD, Rothstein G. Measurement of cutaneous inflammation: estimation of neutrophil content with an enzyme marker. J Invest Dermatol. 1982 Mar;78(3):206-9. doi: 10.1111/1523-1747.ep12506462. PMID: 6276474.
  • National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002 Dec 17;106(25):3143-421. PMID: 12485966.
  • Caliskan B, Korkmaz AN, Erdem F. Contribution of fragmented QRS on myocardial perfusion imaging in the assessment of functionally significant coronary artery stenoses. Eur Rev Med Pharmacol Sci. 2016 Apr;20(8):1575-81. PMID: 27160131.
  • Das MK, Saha C, El Masry H, Peng J, Dandamudi G, Mahenthiran J, McHenry P, Zipes DP. Fragmented QRS on a 12-lead ECG: a predictor of mortality and cardiac events in patients with coronary artery disease. Heart Rhythm. 2007 Nov;4(11):1385-92. doi: 10.1016/j.hrthm.2007.06.024. Epub 2007 Aug 1. PMID: 17954396.
  • Maisel A, Xue Y, Shah K, Mueller C, Nowak R, Peacock WF, Ponikowski P, Mockel M, Hogan C, Wu AH, Richards M, Clopton P, Filippatos GS, Di Somma S, Anand IS, Ng L, Daniels LB, Neath SX, Christenson R, Potocki M, McCord J, Terracciano G, Kremastinos D, Hartmann O, von Haehling S, Bergmann A, Morgenthaler NG, Anker SD. Increased 90-day mortality in patients with acute heart failure with elevated copeptin: secondary results from the Biomarkers in Acute Heart Failure (BACH) study. Circ Heart Fail. 2011 Sep;4(5):613-20. doi: 10.1161/CIRCHEARTFAILURE.110.960096. Epub 2011 Jul 15. PMID: 21765124.
  • Demyanets S, Speidl WS, Tentzeris I, Jarai R, Katsaros KM, Farhan S, Krychtiuk KA, Wonnerth A, Weiss TW, Huber K, Wojta J. Soluble ST2 and interleukin-33 levels in coronary artery disease: relation to disease activity and adverse outcome. PLoS One. 2014 Apr 21;9(4):e95055. doi: 10.1371/journal.pone.0095055. PMID: 24751794; PMCID: PMC3994012.
  • Marino R, Magrini L, Orsini F, Russo V, Cardelli P, Salerno G, Hur M, Di Somma S; GREAT NETWORK. Comparison Between Soluble ST2 and High-Sensitivity Troponin I in Predicting Short-Term Mortality for Patients Presenting to the Emergency Department With Chest Pain. Ann Lab Med. 2017 Mar;37(2):137-146. doi: 10.3343/alm.2017.37.2.137. PMID: 28029000; PMCID: PMC5203991.
  • Aleksova A, Paldino A, Beltrami AP, Padoan L, Iacoviello M, Sinagra G, Emdin M, Maisel AS. Cardiac Biomarkers in the Emergency Department: The Role of Soluble ST2 (sST2) in Acute Heart Failure and Acute Coronary Syndrome-There is Meat on the Bone. J Clin Med. 2019 Feb 22;8(2):270. doi: 10.3390/jcm8020270. PMID: 30813357; PMCID: PMC6406787.
  • Trueblood NA, Xie Z, Communal C, Sam F, Ngoy S, Liaw L, Jenkins AW, Wang J, Sawyer DB, Bing OH, Apstein CS, Colucci WS, Singh K. Exaggerated left ventricular dilation and reduced collagen deposition after myocardial infarction in mice lacking osteopontin. Circ Res. 2001 May 25;88(10):1080-7. doi: 10.1161/hh1001.090842. PMID: 11375279.
  • Szalay G, Sauter M, Haberland M, Zuegel U, Steinmeyer A, Kandolf R, Klingel K. Osteopontin: a fibrosis-related marker molecule in cardiac remodeling of enterovirus myocarditis in the susceptible host. Circ Res. 2009 Apr 10;104(7):851-9. doi: 10.1161/CIRCRESAHA.109.193805. Epub 2009 Feb 26. PMID: 19246678.
  • Mazzone A, Parri MS, Giannessi D, Ravani M, Vaghetti M, Altieri P, Casalino L, Maltinti M, Balbi M, Barsotti A, Berti S. Osteopontin plasma levels and accelerated atherosclerosis in patients with CAD undergoing PCI: a prospective clinical study. Coron Artery Dis. 2011 May;22(3):179-87. doi: 10.1097/MCA.0b013e3283441d0b. PMID: 21407077.
  • Yu K, Yang B, Jiang H, Li J, Yan K, Liu X, Zhou L, Yang H, Li X, Min X, Zhang C, Luo X, Mei W, Sun S, Zhang L, Cheng X, He M, Zhang X, Pan A, Hu FB, Wu T. A multi-stage association study of plasma cytokines identifies osteopontin as a biomarker for acute coronary syndrome risk and severity. Sci Rep. 2019 Mar 26;9(1):5121. doi: 10.1038/s41598-019-41577-4. PMID: 30914768; PMCID: PMC6435654.
  • Rasool Hussein AA, Issa AH, Al-Saffar AF. Role of serum osteopontin and osteoprotegerin levels in the diagnosis of the acute coronary syndrome and its subtypes. Indian Journal of Public Health Research ve Development 2019;10(5):371-76.
  • Gururajan P, Gurumurthy P, Nayar P, Babu S, Sarasabharati A, Victor D, Cherian KM. Serum myeloperoxidase: a novel biomarker for evaluation of patients with acute coronary syndrome. Heart Asia. 2009 Jan 1;1(1):41-6. doi: 10.1136/ha.2009.000778. PMID: 27325926; PMCID: PMC4898491.
  • Goldmann BU, Rudolph V, Rudolph TK, Holle AK, Hillebrandt M, Meinertz T, Baldus S. Neutrophil activation precedes myocardial injury in patients with acute myocardial infarction. Free Radic Biol Med. 2009 Jul 1;47(1):79-83. doi: 10.1016/j.freeradbiomed.2009.04.004. Epub 2009 Apr 9. PMID: 19362143.

Yıl 2023, Cilt: 40 Sayı: 2, 225 - 231, 19.07.2023

Seda Suzan Memecan Tevfik Noyan Osman Bektaş

Öz

Proje Numarası

Project Number: B-1905

Kaynakça

  • Take Y, Morita H. Fragmented QRS: What Is The Meaning? Indian Pacing Electrophysiol J. 2012 Sep;12(5):213-25. doi: 10.1016/s0972-6292(16)30544-7. Epub 2012 Sep 1. PMID: 23071383; PMCID: PMC3443879.
  • Pascual-Figal DA, Januzzi JL. The biology of ST2: the International ST2 Consensus Panel. Am J Cardiol. 2015 Apr 2;115(7 Suppl):3B-7B. doi: 10.1016/j.amjcard.2015.01.034. Epub 2015 Jan 23. PMID: 25665766.
  • Binas D, Daniel H, Richter A, Ruppert V, Schlüter KD, Schieffer B, Pankuweit S. The prognostic value of sST2 and galectin-3 considering different aetiologies in non-ischaemic heart failure. Open Heart. 2018 Feb 26;5(1):e000750. doi: 10.1136/openhrt-2017-000750. PMID: 29531765; PMCID: PMC5845404.
  • You H, Jiang W, Jiao M, Wang X, Jia L, You S, Li Y, Wen H, Jiang H, Yuan H, Huang J, Qiao B, Yang Y, Jin M, Wang Y, Du J. Association of Soluble ST2 Serum Levels With Outcomes in Pediatric Dilated Cardiomyopathy. Can J Cardiol. 2019 Jun;35(6):727-735. doi: 10.1016/j.cjca.2019.02.016. Epub 2019 Feb 27. PMID: 31151708.
  • Aimo A, Migliorini P, Vergaro G, Franzini M, Passino C, Maisel A, Emdin M. The IL-33/ST2 pathway, inflammation and atherosclerosis: Trigger and target? Int J Cardiol. 2018 Sep 15;267:188-192. doi: 10.1016/j.ijcard.2018.05.056. Epub 2018 May 19. PMID: 29793758.
  • Mohamadpour AH, Abdolrahmani L, Mirzaei H, Sahebkar A, Moohebati M, Ghorbani M, Ferns GA, Ghayour-Mobarhan M. Serum osteopontin concentrations in relation to coronary artery disease. Arch Med Res. 2015 Feb;46(2):112-7. doi: 10.1016/j.arcmed.2015.02.005. Epub 2015 Mar 2. PMID: 25743929.
  • Giachelli CM, Bae N, Almeida M, Denhardt DT, Alpers CE, Schwartz SM. Osteopontin is elevated during neointima formation in rat arteries and is a novel component of human atherosclerotic plaques. J Clin Invest. 1993 Oct;92(4):1686-96. doi: 10.1172/JCI116755. PMID: 8408622; PMCID: PMC288328.
  • van der Veen BS, de Winther MP, Heeringa P. Myeloperoxidase: molecular mechanisms of action and their relevance to human health and disease. Antioxid Redox Signal. 2009 Nov;11(11):2899-937. doi: 10.1089/ars.2009.2538. Erratum in: Antioxid Redox Signal. 2010 Feb;12(2):322. Augusto, Ohara [removed];Chen, John W [removed]; Davies, Michael [removed]; Ma,Xin-Liang [removed]; Malle, Ernst [removed]; Pignatelli, Pasquale [removed]; Rudolph, Tanja [removed]. PMID: 19622015.
  • Stocker R, Huang A, Jeranian E, Hou JY, Wu TT, Thomas SR, Keaney JF Jr. Hypochlorous acid impairs endothelium-derived nitric oxide bioactivity through a superoxide-dependent mechanism. Arterioscler Thromb Vasc Biol. 2004 Nov;24(11):2028-33. doi: 10.1161/01.ATV.0000143388.20994.fa. Epub 2004 Aug 26. PMID: 15331437.
  • Sugiyama S, Kugiyama K, Aikawa M, Nakamura S, Ogawa H, Libby P. Hypochlorous acid, a macrophage product, induces endothelial apoptosis and tissue factor expression: involvement of myeloperoxidase-mediated oxidant in plaque erosion and thrombogenesis. Arterioscler Thromb Vasc Biol. 2004 Jul;24(7):1309-14. doi: 10.1161/01.ATV.0000131784.50633.4f. Epub 2004 May 13. PMID: 15142860.
  • Ehrenfeld P, Matus CE, Pavicic F, Toledo C, Nualart F, Gonzalez CB, Burgos RA, Bhoola KD, Figueroa CD. Kinin B1 receptor activation turns on exocytosis of matrix metalloprotease-9 and myeloperoxidase in human neutrophils: involvement of mitogen-activated protein kinase family. J Leukoc Biol. 2009 Nov;86(5):1179-89. doi: 10.1189/jlb.0109012. Epub 2009 Jul 29. PMID: 19641039.
  • Bradley PP, Priebat DA, Christensen RD, Rothstein G. Measurement of cutaneous inflammation: estimation of neutrophil content with an enzyme marker. J Invest Dermatol. 1982 Mar;78(3):206-9. doi: 10.1111/1523-1747.ep12506462. PMID: 6276474.
  • National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002 Dec 17;106(25):3143-421. PMID: 12485966.
  • Caliskan B, Korkmaz AN, Erdem F. Contribution of fragmented QRS on myocardial perfusion imaging in the assessment of functionally significant coronary artery stenoses. Eur Rev Med Pharmacol Sci. 2016 Apr;20(8):1575-81. PMID: 27160131.
  • Das MK, Saha C, El Masry H, Peng J, Dandamudi G, Mahenthiran J, McHenry P, Zipes DP. Fragmented QRS on a 12-lead ECG: a predictor of mortality and cardiac events in patients with coronary artery disease. Heart Rhythm. 2007 Nov;4(11):1385-92. doi: 10.1016/j.hrthm.2007.06.024. Epub 2007 Aug 1. PMID: 17954396.
  • Maisel A, Xue Y, Shah K, Mueller C, Nowak R, Peacock WF, Ponikowski P, Mockel M, Hogan C, Wu AH, Richards M, Clopton P, Filippatos GS, Di Somma S, Anand IS, Ng L, Daniels LB, Neath SX, Christenson R, Potocki M, McCord J, Terracciano G, Kremastinos D, Hartmann O, von Haehling S, Bergmann A, Morgenthaler NG, Anker SD. Increased 90-day mortality in patients with acute heart failure with elevated copeptin: secondary results from the Biomarkers in Acute Heart Failure (BACH) study. Circ Heart Fail. 2011 Sep;4(5):613-20. doi: 10.1161/CIRCHEARTFAILURE.110.960096. Epub 2011 Jul 15. PMID: 21765124.
  • Demyanets S, Speidl WS, Tentzeris I, Jarai R, Katsaros KM, Farhan S, Krychtiuk KA, Wonnerth A, Weiss TW, Huber K, Wojta J. Soluble ST2 and interleukin-33 levels in coronary artery disease: relation to disease activity and adverse outcome. PLoS One. 2014 Apr 21;9(4):e95055. doi: 10.1371/journal.pone.0095055. PMID: 24751794; PMCID: PMC3994012.
  • Marino R, Magrini L, Orsini F, Russo V, Cardelli P, Salerno G, Hur M, Di Somma S; GREAT NETWORK. Comparison Between Soluble ST2 and High-Sensitivity Troponin I in Predicting Short-Term Mortality for Patients Presenting to the Emergency Department With Chest Pain. Ann Lab Med. 2017 Mar;37(2):137-146. doi: 10.3343/alm.2017.37.2.137. PMID: 28029000; PMCID: PMC5203991.
  • Aleksova A, Paldino A, Beltrami AP, Padoan L, Iacoviello M, Sinagra G, Emdin M, Maisel AS. Cardiac Biomarkers in the Emergency Department: The Role of Soluble ST2 (sST2) in Acute Heart Failure and Acute Coronary Syndrome-There is Meat on the Bone. J Clin Med. 2019 Feb 22;8(2):270. doi: 10.3390/jcm8020270. PMID: 30813357; PMCID: PMC6406787.
  • Trueblood NA, Xie Z, Communal C, Sam F, Ngoy S, Liaw L, Jenkins AW, Wang J, Sawyer DB, Bing OH, Apstein CS, Colucci WS, Singh K. Exaggerated left ventricular dilation and reduced collagen deposition after myocardial infarction in mice lacking osteopontin. Circ Res. 2001 May 25;88(10):1080-7. doi: 10.1161/hh1001.090842. PMID: 11375279.
  • Szalay G, Sauter M, Haberland M, Zuegel U, Steinmeyer A, Kandolf R, Klingel K. Osteopontin: a fibrosis-related marker molecule in cardiac remodeling of enterovirus myocarditis in the susceptible host. Circ Res. 2009 Apr 10;104(7):851-9. doi: 10.1161/CIRCRESAHA.109.193805. Epub 2009 Feb 26. PMID: 19246678.
  • Mazzone A, Parri MS, Giannessi D, Ravani M, Vaghetti M, Altieri P, Casalino L, Maltinti M, Balbi M, Barsotti A, Berti S. Osteopontin plasma levels and accelerated atherosclerosis in patients with CAD undergoing PCI: a prospective clinical study. Coron Artery Dis. 2011 May;22(3):179-87. doi: 10.1097/MCA.0b013e3283441d0b. PMID: 21407077.
  • Yu K, Yang B, Jiang H, Li J, Yan K, Liu X, Zhou L, Yang H, Li X, Min X, Zhang C, Luo X, Mei W, Sun S, Zhang L, Cheng X, He M, Zhang X, Pan A, Hu FB, Wu T. A multi-stage association study of plasma cytokines identifies osteopontin as a biomarker for acute coronary syndrome risk and severity. Sci Rep. 2019 Mar 26;9(1):5121. doi: 10.1038/s41598-019-41577-4. PMID: 30914768; PMCID: PMC6435654.
  • Rasool Hussein AA, Issa AH, Al-Saffar AF. Role of serum osteopontin and osteoprotegerin levels in the diagnosis of the acute coronary syndrome and its subtypes. Indian Journal of Public Health Research ve Development 2019;10(5):371-76.
  • Gururajan P, Gurumurthy P, Nayar P, Babu S, Sarasabharati A, Victor D, Cherian KM. Serum myeloperoxidase: a novel biomarker for evaluation of patients with acute coronary syndrome. Heart Asia. 2009 Jan 1;1(1):41-6. doi: 10.1136/ha.2009.000778. PMID: 27325926; PMCID: PMC4898491.
  • Goldmann BU, Rudolph V, Rudolph TK, Holle AK, Hillebrandt M, Meinertz T, Baldus S. Neutrophil activation precedes myocardial injury in patients with acute myocardial infarction. Free Radic Biol Med. 2009 Jul 1;47(1):79-83. doi: 10.1016/j.freeradbiomed.2009.04.004. Epub 2009 Apr 9. PMID: 19362143.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Research Article
Yazarlar

Seda Suzan Memecan 0000-0002-3957-3135

Tevfik Noyan 0000-0002-7733-0177

Osman Bektaş 0000-0002-6616-9891

Proje Numarası Project Number: B-1905
Erken Görünüm Tarihi 1 Ağustos 2023
Yayımlanma Tarihi 19 Temmuz 2023
Gönderilme Tarihi 17 Ekim 2022
Kabul Tarihi 15 Şubat 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 40 Sayı: 2

Kaynak Göster

APA Memecan, S. S., Noyan, T., & Bektaş, O. (2023). Osteopontin, Suppression of Tumorgenicity 2 and Myeloperoxidase Levels in Acute Coronary Syndrome Patients with Fragmented QRS. Journal of Experimental and Clinical Medicine, 40(2), 225-231.
AMA Memecan SS, Noyan T, Bektaş O. Osteopontin, Suppression of Tumorgenicity 2 and Myeloperoxidase Levels in Acute Coronary Syndrome Patients with Fragmented QRS. J. Exp. Clin. Med. Temmuz 2023;40(2):225-231.
Chicago Memecan, Seda Suzan, Tevfik Noyan, ve Osman Bektaş. “Osteopontin, Suppression of Tumorgenicity 2 and Myeloperoxidase Levels in Acute Coronary Syndrome Patients With Fragmented QRS”. Journal of Experimental and Clinical Medicine 40, sy. 2 (Temmuz 2023): 225-31.
EndNote Memecan SS, Noyan T, Bektaş O (01 Temmuz 2023) Osteopontin, Suppression of Tumorgenicity 2 and Myeloperoxidase Levels in Acute Coronary Syndrome Patients with Fragmented QRS. Journal of Experimental and Clinical Medicine 40 2 225–231.
IEEE S. S. Memecan, T. Noyan, ve O. Bektaş, “Osteopontin, Suppression of Tumorgenicity 2 and Myeloperoxidase Levels in Acute Coronary Syndrome Patients with Fragmented QRS”, J. Exp. Clin. Med., c. 40, sy. 2, ss. 225–231, 2023.
ISNAD Memecan, Seda Suzan vd. “Osteopontin, Suppression of Tumorgenicity 2 and Myeloperoxidase Levels in Acute Coronary Syndrome Patients With Fragmented QRS”. Journal of Experimental and Clinical Medicine 40/2 (Temmuz 2023), 225-231.
JAMA Memecan SS, Noyan T, Bektaş O. Osteopontin, Suppression of Tumorgenicity 2 and Myeloperoxidase Levels in Acute Coronary Syndrome Patients with Fragmented QRS. J. Exp. Clin. Med. 2023;40:225–231.
MLA Memecan, Seda Suzan vd. “Osteopontin, Suppression of Tumorgenicity 2 and Myeloperoxidase Levels in Acute Coronary Syndrome Patients With Fragmented QRS”. Journal of Experimental and Clinical Medicine, c. 40, sy. 2, 2023, ss. 225-31.
Vancouver Memecan SS, Noyan T, Bektaş O. Osteopontin, Suppression of Tumorgenicity 2 and Myeloperoxidase Levels in Acute Coronary Syndrome Patients with Fragmented QRS. J. Exp. Clin. Med. 2023;40(2):225-31.
 Kapak Resmi İndir

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