Elevated levels of circulating soluble ST2 at discharge predict late adverse ventricular remodeling in patients with ST-segment elevation myocardial infarction
Open Access
- 8 December 2018
- journal article
- research article
- Published by Biomedical Research and Therapy in Biomedical Research and Therapy
- Vol. 5 (12), 2863-2875
- https://doi.org/10.15419/bmrat.v5i12.505
Abstract
Introduction: The aim of this study was to investigate whether the circulating level of sST2 would predict adverse LV remodeling in STEMI patients with TIMI III flow through the myocardial infarctrelated coronary artery six months after intervention. Methods: The study retrospectively included 65 patients with STEMI and TIMI-III flow after primary or facilitated percutaneous coronary intervention (PCI). These patients were admitted to the intensive care unit of L.T. Malaya Therapy National Institute between August 2016 and July 2018. Primary PCI with bare-metal stent implantation was performed in 33 patients, and 32 patients were previously treated with primary thrombolysis followed by PCI within 12 hours after initial STEMI confirmation. Angiographic, clinical, and biochemical parameters were evaluated. B-mode, Tissue Doppler, Strain Echocardiography, and blood sampling for biomarker assays were performed at admission, at discharge from the hospital, and at six months after STEMI. Results: Late adverse LV remodeling is defined as an increase of LV end-diastolic volume (EDV) six months post STEMI (first cohort, n=29), while other patients (second cohort, n=36) did not demonstrate a decreasing trend of LV EDV, or they had never revealed any decrease of this parameter. There was a significant difference between the two cohorts in the serum level of sST2 at discharge, while the levels of natriuretic peptides, troponin I were similar (P=0.24). Indeed, the circulating level of sST2 in the first cohort was higher than that of the second cohort (59.72 ng/mL; 95% confidence interval [CI] = 36.99 ng/mL -139.53 ng/mL versus 44.75 ng/mL; 95%CI =28.25 ng/mL -77.32 ng/mL, P=0.039, respectively). ROC-analyses showed that the best balanced cut-off point for sST2 to predict adverse remodeling at 6 months post PCI was 35 ng/mL (AUC=0.672 95% C 0.523-0.799; P=0.0344 sensitivity = 46.7% and specificity = 85.7%). Conclusions: We showed that the circulating level of sST2 measured at discharge in acute STEMI patients intervented by PCI could predict late adverse LV remodeling six months post PCI. These findings offer a new biomarker to stratify patients with successful coronary re-vascularization at risk of HF.Keywords
This publication has 33 references indexed in Scilit:
- Heart Failure Therapy–Induced Early ST2 Changes May Offer Long-Term Therapy GuidanceJournal of Cardiac Failure, 2013
- ST2 as a Cardiovascular Risk Biomarker: From the Bench to the BedsideJournal of Cardiovascular Translational Research, 2013
- Soluble ST2 Associates with Diabetes but Not Established Cardiovascular Risk Factors: A New Inflammatory Pathway of Relevance to Diabetes?PLOS ONE, 2012
- Serial Monitoring of Soluble Interleukin Family Member ST2 in Patients with Acutely Decompensated Heart FailureCardiology, 2012
- Role of ST2 in Non–ST-Elevation Acute Coronary Syndrome in the MERLIN-TIMI 36 TrialClinical Chemistry, 2012
- Serum Soluble ST2: A Potential Novel Mediator in Left Ventricular and Infarct Remodeling After Acute Myocardial InfarctionJournal of Invasive Cardiology, 2010
- Complementary Roles for Biomarkers of Biomechanical Strain ST2 and N-Terminal Prohormone B-Type Natriuretic Peptide in Patients With ST-Elevation Myocardial InfarctionJournal of the American College of Cardiology, 2008
- Abciximab in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention After Clopidogrel PretreatmentThe ISAR-REACT 2 Randomized TrialJAMA, 2006
- Current percutaneous coronary intervention and coronary artery bypass grafting practices for three-vessel and left main coronary artery disease.☆Insights from the SYNTAX run-in phaseEuropean Journal of Cardio-Thoracic Surgery, 2006
- Recommendations for Chamber Quantification: A Report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of CardiologyJournal of the American Society of Echocardiography, 2005