Soluble ST2 and Interleukin-33 Levels in Coronary Artery Disease: Relation to Disease Activity and Adverse Outcome

Abstract

ObjectivesST2 is a receptor for interleukin (IL)-33. We investigated an association of soluble ST2 (sST2) and IL-33 serum levels with different clinical stages of coronary artery disease. We assessed the predictive value of sST2 and IL-33 in patients with stable angina, non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI).MethodsWe included 373 patients of whom 178 had stable angina, 97 had NSTEMI, and 98 had STEMI. Patients were followed for a mean of 43 months. The control group consisted of 65 individuals without significant stenosis on coronary angiography. Serum levels of sST2 and IL-33 were measured by ELISAs.ResultssST2 levels were significantly increased in patients with STEMI as compared to patients with NSTEMI and stable angina as well as with controls. IL-33 levels did not differ between the four groups. During follow-up, 37 (10%) patients died and the combined endpoint (all cause death, MI and rehospitalisation for cardiac causes) occurred in 66 (17.6%) patients. sST2 serum levels significantly predicted mortality in the total cohort. When patients were stratified according to their clinical presentation, the highest quintile of sST2 significantly predicted mortality in patients with STEMI, but not with NSTEMI or stable coronary artery disease. sST2 was a significant predictor for the combined endpoint in STEMI patients and in patients with stable angina. Serum levels of IL-33 were not associated with clinical outcome in the total cohort, but the highest quintile of IL-33 predicted mortality in patients with STEMI.ConclusionsSerum levels of sST2 are increased in patients with acute coronary syndromes as compared to levels in patients with stable coronary artery disease and in individuals without coronary artery disease. sST2 and IL-33 were associated with mortality in patients with STEMI but not in patients with NSTEMI or stable angina.

Evaluation of soluble ST2 as a novel cardiovascular biomarker in patients with acute myocardial infarction

“…14 No difference in severity of the disease with respect to angiographic findings in present study. Patients with STEMI showed the highest serum levels of soluble ST-2 in a study performed by Demyanets S et al 20 …”

“…In contrast most of the other studies have used R&D systems. 3,20 In present study the blood sample was collected within 48 hours after onset of MI. There is considerable variation in the timing of sample collected in the earlier studies.…”

Are Inflammatory Cytokines Associated with Pain during Acute Myocardial Infarction?

“…Several studies showed an association between worse cardiovascular outcome and increased TNF-α [23] and IL-6 [24][25][26] levels specifically following an acute coronary syndrome (ACS). However, despite their anti-inflammatory properties during MI, both IL-33 [27,28] and TGF-β [29] have been found to be associated with a worse prognosis in coronary artery disease.…”

Prognostic biomarkers in acute coronary syndrome

“…They found that sST2 levels were significantly increased in patients with ACS as compared to patients with stable coronary artery disease and control individuals without significant stenosis on coronary angiography (44). The same research group showed that the level of circulating sST2 is associated with the stage of coronary artery disease and is increased continuously from stable coronary artery disease to NSTEMI and STEMI.…”