Bone morphogenetic protein-2 will be a novel biochemical marker in urinary tract infections and stone formation.

OBJECTIVES: To investigate the role of bone morphogenetic protein-2 (BMP-2) in patients with urinary tract infection (UTI) and renal stone in relation to Tamm-Horsfall protein (THP) and osteopontin (OPN). DESIGN AND METHODS: ELISA kits were used to determine these markers in serum and urinary samples of 20 patients with UTI, 15 with renal stone and 10 controls. RESULTS: BMP-2 significantly increased in serum of patients who had UTI (P=0.05) and renal stone (P=0.01). In the case of UTI, serum BMP-2 at cutoff 44 pg/mL had sensitivity and specificity (92%, 80%), while cystatin C at cutoff 525 ng/mL showed sensitivity and specificity (85%, 91%). THP is a good predictor of renal diseases (P<0.001) by regression analysis. It is also the most sensitive urinary marker for UTI with sensitivity and specificity (94%, 75%) at cutoff 305 ng/mL. CONCLUSION: Combination of serum BMP-2 and cystatin C are more sensitive and accurate for early diagnosis of renal infection and damage.

N-TerminaL PRO-BNP in Acute Coronary Syndrome Patients with ST Elevation Versus Non ST Elevation in Qassim Region of Saudi Arabia.

AIM: To investigate the differences in the secretion of NT-proBNP and conventional cardiac markers in patients with STE-ACS vs. NSTE-ACS as a trial to solve the dilemma of the early detection of myocardial ischemia in NSTE-ACS. DESIGN: prospective case control hospital based study. SETTING: King Fahad Specialist Hospital, Buraidah, Kingdom of Saudi Arabia. PATIENTS AND METHODS: Sixty two patients with acute coronary syndrome (ACS) were divided into 2 groups according to ECG: group1 with elevated ST segment in ECG ( STE-ACS) and group 2 with non elevated ST segment (NSTE-ACS). Twenty healthy subjects with matched age and sex were enrolled as control group in this study. In the sera of all subjects, levels of NT -proBNP, CK-MB and troponin- T were measured by different kits. RESULTS: CK-MB and Tn-T were both significantly higher in STE-ACS patients as compared to NSTE-ACS patients. Conversely, NT-proBNP was significantly higher in NSTE-ACS patients than STE-ACS especially within 4 hours from onset of chest pain. This suggested a larger ischemic insult despite the smaller extent of myocardial necrosis compared with STE-ACS patients. Comparison between sensitivity and specificity of NT-proBNP, Tn-T and CK-MB levels by ROC curves revealed a marked difference of area under the curves with higher sensitivity and specificity of NT-proBNP in NSTE-ACS patients. CONCLUSIONS: NT-proBNP can serve as a sensitive marker in the early phase of NSTE-ACS patients as compared to conventional markers of myocardial damage.