Soluble ST2 in Predicting Adverse Outcome after Revascularization with Percutaneous Coronary Intervention in Patients with ST-Elevation Myocardial Infarction

Abstract

Aim: The aim of the study was to investigate the relationship between the soluble suppression of tumorigenicity 2 (sST2) level and the degree of epicardial blood flow recovery in patients with myocardial infarction with ST-segment elevation (STEMI) after percutaneous coronary intervention. Material and Methods: The study involved 61 patients (83.6% males), with a mean age of 59.85±10.01 years. sST2 level was measured by enzyme immunoassay. Patients were divided into two groups. The first group (n=12) included patients with thrombolysis in myocardial infarction (TIMI) ≤II flow grade, the second group (n=49) with TIMI III flow grade. Results: The sST2 level was significantly higher in the first hours of the disease in the group with decreased epicardial blood flow (TIMI ≤II) after percutaneous coronary intervention (p=0.003). Receiver operating characteristics curve analysis showed that sST2 levels over 34.2 ng/ml, detected on admission, was an independent predictor of adverse revascularization (TIMI ≤II) in patients with STEMI with a sensitivity of 92.3% and a specificity of 62.5%; the area under curve was 0.811 (95% CI: 0.651 - 0.873; p=0.001). Both the univariate (OR: 1.020, 95% CI: 1.001-1.041, p=0.028) and multivariate (OR: 1.030; 95% CI: 1.002-1.057; p=0.033) analyzes showed that sST2 was a significant predictor of the unfavorable outcome of epicardial vascular revascularization (TIMI ≤ІІ). Conclusion: sST2 is highly associated with the degree of blood flow recovery after percutaneous coronary intervention in patients with STEMI and is of great clinical importance as a prognostic marker.