Soluble ST2 association with outcome of revascularization and the heart failure development in patients with acute myocardial infarction with ST segment elevation

Abstract

The aim – to study the relationship between the sST2 level and the degree of epicardial blood flow recovery and with the heart failure (HF) development in 6 month follow-up in patients with STEMI after PCI.Materials and methods. The study involved 61 patients with STEMI – 51 (83.6 %) males and 10 (16.4 %) females, with average age of 59.85±10.01 years. Standard clinical and biochemical parameters were determined, as well as sST2 level was measured by enzyme immunoassay using a reagent kit «Presage ST2 analysis, Critical Diagnosis» (USA) in all patients, on the first day of the disease. Patients were divided into two groups depending on the degree of blood flow recovery in a culprit artery (TIMI) The first group (n=12) included patients with TIMI 0, I, II, the second group (n=49) with TIMI III.Results and discussion. The sST2 level was significantly higher in the first hours of the disease in the group with unrepaired or decreased epicardial blood flow (TIMI 0–II) after PCI (p=0.003). ROC analysis showed that sST2 levels above 34.2 ng/ml, detected in the first hours of the disease, is an independent marker of adverse revascularization (TIMI 0–I) in patients with STEMI with a sensitivity of 92.3 % and a specificity of 62.5 %; the area under curve (the AUC) is 0.8 (95 % CI=0.651–0.873; p=0.001). When conducting a univariate (χ2=17.741; p=0.04) and multivariate (χ2=9.293; p=0.004) logistic analyzes, sST2 was a significant influencer of the unfavorable outcome of epicardial vascular revascularization (TIMI 0–ІІ).Conclusions. sST2 is highly associated with the degree of epicardial blood flow recovery in patients with STEMI and is of great clinical importance as diagnostic marker.