Soluble ST2 for Prediction of Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction Receiving Primary PCI

Abstract

Soluble suppression of tumorigenicity 2 (sST2), a biomarker representing myocardial fibrosis and inflammation, has been applied in risk stratification of patients with myocardial infarction (MI). However, whether primary PCI (PPCI) will eliminate the predictive value of sST2 in STEMI patients has not been well studied.Here, we conducted a prospective clinical trial to evaluate the correlation between sST2 and prognosis in STEMI patients undergoing PPCI. sST2 levels were measured in 295 STEMI patients (60.2 ± 10.8 years) at admission using a high sensitivity assay. Baseline sST2 levels were significantly associated with heart function, biomarkers of inflammation, and myocardial injury. During a 12-month follow-up, 19 patients had major adverse cardiovascular events (MACEs). Greater sST2 was continuously associated with a higher risk of incident MACEs. Such association remained even after adjusting for other risk factors in a multivariate Cox analysis. A baseline sST2 level in the highest quartile (!58.7 ng/mL) was independently associated with mortality (HR: 5.01, 95%CI: 1.02-16.30, P = 0.048). More incident heart failure was seen in the group with greater sST2, however, the association was not significant after adjustment. Therefore, baseline sST2 may be useful to predict MACEs, especially mortality, in STEMI patients receiving PPCI.

The Predictive Value of the Combination of Soluble ST2 and N Terminal-Pro Brain Natriuretic Peptide for Short-Term Mortality in ST-Elevation Myocardial Infarction Patients with Poor PostProcedural TIMI Flow

“…In another large study, the multi-marker model was examined in the post-MI risk classification, and this study indicated that sST2 predicted short-term mortality both alone and in combination with other biomarkers (alone (2.88; 1.72-4.81)/multimarker (2.88; 1.72-4.81 5.12) (21) . In addition, Liu et al determined that the highest quartile sST2 (> 58.7 ng/mL) could predict 1-year mortality in STEMI patients (HR 5.01, 95%CI 1.02-16.30, p = 0.048) (22) . We carried out our study in a more specific group of patients with post-procedural poor TIMI flow and observed that the presence of high sST2 predicted short-term mortality, a result that is parallel to those of the above-mentioned studies.…”

The association between soluble suppression of tumorigenicity-2 and long-term prognosis in patients with coronary artery disease: A meta-analysis

“…The literature search process is summarized in Fig 1. We identified 159 articles from PubMed, 1,585 from Embase, and 41 from the Cochrane Library. Among them, 22 articles that enrolled a total of 17,432 patients with CAD investigated the relationship between baseline sST2 levels and long-term clinical outcomes in patients with CAD were included [12,13,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. In these studies, the baseline sST2 level was provided as a categorical variable (18 articles) or a continuous variable (8 articles).…”

Major Adverse Cardiovascular Events: An Inevitable Outcome of ST-elevation myocardial infarction? A Literature Review

“…-Five studies that identified themselves as RCT and eight other studies that identified themselves as clinical trials [7][8][9][10][11][12][13][14][15][16][17][18][19].…”