Author + information
Although suppression of tumorigenicity 2 (ST2) in serum is known to be associated with ischemic heart disease and heart failure, data regarding its prognostic impact in ST-segment elevation myocardial infarction (STEMI) is limited. Thus, the authors evaluated the prognostic impacts of serum ST2 and other serum biomarkers in STEMI patients undergoing primary percutaneous coronary intervention (PCI).
All 323 patients with STEMI that underwent primary PCI at the Gachon University Gil Medical Center from 2011 to 2015 were enrolled. Blood tests and samples were obtained in an emergency room. The primary endpoint was 1-year major adverse cardiovascular and cerebrovascular events (MACCEs), defined as a composite of cardiovascular death, non-fatal MI, non-fatal stroke, and ischemia-driven revascularization.
Mean patient age was 59.1±13.1 years (Men 84%). MACCE (20 cardiovascular deaths, 7 non-fatal MI, 4 non-fatal stroke, 7 ischemia-driven revascularizations) occurred in 38 patients (12%). After adjusting for confounding factors, Cox regression analysis revealed that high serum ST2 (>75.4 ng/ml, adjusted hazard ratio 2.12, 95% CI 1.04-4.32, p=0.038) and high serum NT-proBNP level (>400 pg/ml, adjusted hazard ratio 3.42, 95 % CI 1.73-6.77, p<0.001) at time of presentation independently predicted MACCE within one year of primary PCI. Furthermore, when high serum ST2 level was combined with high serum NT-proBNP level, the hazard ratio of MACCE was highest (adjusted hazard ratio 8.17, 95% CI 3.01-22.21, p<0.001). Survival probability plots of 1-year MACCE showed high serum ST2 was associated with poorer prognosis, and that the presence of high serum ST2 and high serum NT-proBNP was associated with an even poorer prognosis.
Elevated serum levels of ST2 or NT-proBNP at time of presentation were found to predict MACCE independently within one year of PCI, and survival probability plots of 1-year MACCE revealed that elevated serum levels of ST2 plus NT-proBNP were associated with even poorer prognosis in patients with STEMI after primary PCI.
CORONARY: PCI Outcomes