Efficacy of lipid, NT-proBNP and D-dimer biomarkers in the differential diagnosis of patients presenting to the emergency department with syncope

Abstract

Aims: Syncope is defined as a temporary loss of consciousness in any disorder characterized by a self-limited loss of consciousness, whatever the mechanism. It constitutes 3% of emergency service applications. NT-proBNP, D-dimer and lipids are important parameters in the diagnosis and differential diagnosis of patients with syncope. This study aims to determine the levels of these biomarkers during and after treatment in patients admitted to the emergency department(ED) due to syncope. Methods: Forty-nine patients admitted to the emergency department due to syncope were included in this study. Forty-nine age- and sex-matched individuals without a history of syncope were taken as the control group. Blood samples were taken from the patient group three times, at the time of admission to the emergency department, 24 hours after admission, and on the day they were discharged from the hospital, and only once from the control group. The patient and control groups were compared in terms of NT-proBNP, D-dimer and lipids. Results: The mean HDL level at discharge was 33.63±9.62 mg/dl, which was significantly lower than the mean HDL level in the control group (38.77±10.33 mg/dl) (t=2.14, p=0.012). Although the mean LDL levels at discharge (108.02±48.03 mg/dl) were higher than the control group (92.53±37.39 mg/dl), this increase was not statistically significant (t=1.78, p=0.078). However, the mean LDL levels during hospitalization and after 24 hours (126.08±51.88 mg/dl, 116.26±48.21 mg/dl, respectively) compared to the control group (92.53±7.39 mg/dl) were statistically significantly higher (t=3.67, p=0.001, t=2.73, p=0.008). NT proBNP and D-dimer median values at the time of admission to the emergency department (844.00 pg/ml, 616.50 mcg/L, respectively), after 24 hours (1985.00 pg/ml, 662.00 mcg/L, respectively) and at discharge (748.00 pg/ml, 702.50 mcg/L respectively) compared to the control group (85.00 pg/ml, 176.00 mcg/L, respectively), a statistically significant increase was detected (p=0.001). Conclusion: In the patients admitted to the ED with a diagnosis of syncope, early treatment can be achieved getting the differential diagnosis of syncope in a short time with NT-proBNP, D-dimer and lipid blood levels that can be worked easily. In addition, the need for serious interventional procedures and further investigations in the diagnostic process will be reduced.