Association between bone morphogenetic protein 2 and interleukin 6 in patients with acute coronary syndrome

Objective: To investigate the association between serum concentrations of bone morphogenetic protein 2 (BMP2) and interleukin‑6 (IL‑6) in patients diagnosed with acute coronary syndrome (ACS). Methods: A case‑control study was conducted at Merjan Teaching Hospital, Iraq, from November 2025 to February 2026. The study included 60 patients with ACS and 60 healthy controls. Serum BMP2 and IL‑6 levels were measured using enzyme‑linked immunosorbent assay (ELISA). Results: ACS patients had significantly higher serum BMP2 (2.53±1.0 ng/L vs. 1.55±0.37 ng/L; p<0.0001) and IL‑6 (74.7±27.5 ng/mL vs. 48±10.3 ng/mL; p<0.0001) compared to controls. Receiver operating characteristic (ROC) analysis showed excellent diagnostic performance for BMP2 (area under the curve, AUC=0.86) and IL‑6 (AUC=0.88). IL‑6 levels differed significantly across ACS subtypes (p=0.0008), being highest in unstable angina (UA), whereas BMP2 levels showed no significant variation (p=0.61). Conclusions: Elevated BMP2 and IL‑6 are strongly associated with ACS and reflect the interplay of inflammation and vascular dysfunction. Their high diagnostic accuracy supports their potential as clinical tools for risk stratification, although BMP2 does not differentiate between ACS subtypes.