Combining SST2 and NT-proBNP for improved risk stratification in STEMI patients post-PCI

Background and objectives. Soluble suppression of tumorigenicity-2 (sST2), a member of the interleukin-1 receptor family, has shown prognostic value in various cardiovascular conditions. However, its role in predicting short-term adverse events in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) remains unclear. This study aimed to investigate the correlation between sST2 levels and prognosis in STEMI patients treated with primary PCI. Materials and methods. In this single-center, prospective, observational study, 35 patients with STEMI who underwent primary PCI were monitored for sST2 levels and major adverse cardiac events (MACE) during hospitalization and within 30 days post-discharge. The correlation between sST2 levels and cardiovascular risk scores was also evaluated. Results. The mean sST2 level was 50.55 ± 50.54 ng/ml, with a moderate positive correlation observed between sST2 and NT-proBNP levels (r = 0.46, p < 0.01), and TIMI (r = 0.58) and GRACE (r = 0.67) risk scores (p < 0.001). sST2 levels were significantly higher in patients who died and/or experienced heart failure during hospitalization (p < 0.005) and within 30 days (p < 0.005). The cutoff values for predicting in-hospital death/heart failure and events within 30 days were 58.50 ng/ml (AUC 0.882, p < 0.001) and 44.57 ng/ml (AUC 0.804, p < 0.005). Combining sST2 and NT-proBNP levels improved the predictive accuracy for short-term adverse events. Conclusions. sST2 is a valuable biomarker for predicting short-term adverse cardiovascular events, including death and/or heart failure, in STEMI patients undergoing primary PCI. The combination of sST2 and NT-proBNP levels further enhanced prognostic accuracy.