Serum Soluble ST2 and Adverse Left Ventricular Remodeling in Patients With ST-Segment Elevation Myocardial Infarction

Abstract

Objective: To assess the dynamics of serum levels of soluble isoform of suppression of tumorigenicity 2 (sST2) and N-terminal pro-brain natriuretic peptide (NT-proBNP) and their correlations with the development of adverse left ventricular remodeling (LVR) through 6 months in patients with primary myocardial infarction with ST-segment elevation (STEMI). Methods: Subjects were 31 patients with STEMI (median age: 58 years), who underwent percutaneous coronary intervention (PCI) during the first 24 hours of the onset of myocardial infarction (MI). Blood samples and parameters of echocardiography were assessed at days 1, 3, 7, and 14 and 6 months after STEMI. Results: Serum levels of sST2 and NT-proBNP decreased during the 6-month period. Levels of sST2 decreased by 48% from admission to day 7, and levels of NT-proBNP decreased by 40% from day 7 to 6 months after STEMI. Serum levels of sST2 at day 1 ( r = 0.5, P < .05) and day 3 ( r = 0.4, P < .05) were associated with adverse LVR by 6 months after STEMI. Logistic regression analysis showed that a high concentration of sST2 at day 7 increased the risk of adverse LVR (95% confidence interval [CI], 0.5-0.9; areas under curve [AUC] = 0.8; P = .002), with 92% sensitivity and 70% specificity. A multivariate analysis model revealed that adverse LVR was associated with the level of sST2 ( P = .003) and with complete revascularization ( P = .01) at the admission. Conclusions: The dynamics of serum levels of sST2 and NT-proBNP were different. The level of sST2 normalized by the 7th day; NT-proBNP decreased only by the end of the 6-month period after MI. Increased serum levels of sST2 by the 7th day of MI were associated with the development of adverse LVR by the end of the 6-month period.

Serum Levels of Bone Morphogenetic Proteins 2 and 4 in Patients with Acute Myocardial Infarction

“…The study involved 31 patients (mean age 58.3 ± 9.8 years) with STEMI who were admitted to the emergency cardiology department between 1 March 2014 and 1 March 2015 [ 4 ]. The medical history and vital signs of patients are presented in Table 1 and Table 2 .…”

“…The study involved 31 patients with acute primary anterior STEMI who were admitted to the emergency cardiology department during the first 24 h from the onset of MI [ 4 ]. Percutaneous coronary intervention (PCI) was performed on the first day of hospitalization.…”

“…STEMI was diagnosed based on the third universal definition of MI [ 2 ]. Echocardiography was performed in all patients at Days 3 (T2), 7 (T3) and 14 (T4) and six months (T5) after STEMI onset (Vivid E9, GE Healthcare, Boston, MA, USA) [ 4 , 11 , 12 ]. The obtained images were stored on CD-ROM drives and then analyzed using GE EchoPAC software (GE, Healthcare, EchoPac 113, Boston, MA, USA).…”

“…Left ventricle (LV) end-diastolic volume (EDV) and end-systolic volume (ESV) and the LV ejection fraction (EF) were estimated using the biplane Simpson’s method [ 13 ]. We assessed the development of adverse LVR in the early (by the 14th day) and late (by six months) periods after AMI according to the enlargement of EDV and/or ESV LV more than 20% from the baseline data [ 4 ].…”

“…Chronic aseptic inflammation that occurs under hemodynamic stress and is characterized by the formation of fibrotic scar tissue is a basis for the development of post-infarction adverse left ventricular remodeling (LVR) and CHF progression [ 1 , 3 ]. In our previous research, we obtained data on cell–molecular predictors of the adverse LVR [ 4 ]. However, the mechanism of LVR development and the roles of the inflammatory response and fibrogenesis in heart remodeling remain poorly understood [ 5 , 6 ].…”