Key result
Elevated baseline sST2 fails to independently predict major adverse cardiac and cerebrovascular events.
Why the study?
The clinical relevance of soluble suppression of tumorigenicity-2 (sST2) levels in patients undergoing PCI remains incompletely defined.
Does elevated baseline soluble ST2 level predict major adverse cardiac and cerebrovascular events and mortality in patients with coronary artery disease undergoing percutaneous coronary intervention?
Cohort (n=758)
No
Does elevated baseline soluble ST2 level predict major adverse cardiac and cerebrovascular events and mortality in patients with coronary artery disease undergoing percutaneous coronary intervention?
Hazard Ratio: 3.28 (95% CI 0.91–11.83)
Absolute Event Rate: 4.2% vs 0.8%
p-value: p=0.070
Elevated baseline sST2 levels in patients undergoing PCI are associated with increased long-term all-cause mortality and may help identify high-risk phenotypes.
Elevated sST2 should not yet inform post-PCI risk stratification; leaves open whether it independently predicts MACCE after fuller confounder adjustment.
Background and Objectives: Soluble suppression of tumorigenicity-2 (sST2) is a biomarker associated with myocardial stress, inflammation, and fibrosis. Although elevated sST2 levels have demonstrated prognostic significance in heart failure and acute coronary syndromes, their clinical relevance in patients undergoing percutaneous coronary intervention (PCI) remains incompletely defined. This study aimed to evaluate the association between baseline serum sST2 levels and long-term clinical outcomes in an unselected real-world cohort of patients undergoing PCI. Materials and Methods: A total of 758 consecutive patients with coronary artery disease who underwent PCI between September 2015 and November 2017 were enrolled. Baseline serum sST2 levels were measured before PCI, and patients were stratified according to the median value (28.3 ng/mL). The primary endpoint was major adverse cardiac and cerebrovascular events (MACCEs), defined as a composite of cardiac death, nonfatal myocardial infarction, and nonfatal stroke. Multivariable Cox proportional hazards models and receiver operating characteristic analyses were performed to assess the association of sST2 with clinical outcomes and its discriminatory ability. Results: During a median follow-up of 28.3 months, MACCEs occurred in 19 patients (2.5%). Patients with higher sST2 levels had significantly higher rates of MACCEs (4.2% vs. 0.8%, p = 0.005) and all-cause mortality (11.9% vs. 2.6%, p < 0.001) than those with lower sST2 levels. Although the association between elevated sST2 and MACCE was attenuated after multivariable adjustment (adjusted hazard ratio, 3.28; 95% confidence interval, 0.91–11.83; p = 0.070), receiver operating characteristic analysis demonstrated moderate predictive performance for MACCE (AUC, 0.723) and all-cause mortality (AUC, 0.763). The optimal cutoff value for predicting MACCE was 52.2 ng/mL. Conclusions: Elevated baseline serum sST2 levels were associated with adverse long-term clinical outcomes in an unselected, real-world cohort of patients undergoing PCI. Further studies are warranted to clarify its prognostic role in this population.
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Byeon et al. (2026) conducted a cohort in Coronary artery disease (n=758). Elevated baseline serum soluble ST2 (sST2) levels vs. Lower baseline sST2 levels was evaluated on Major adverse cardiac and cerebrovascular events (MACCEs) (adjusted HR 3.28, 95% CI 0.91-11.83, p=0.070). Elevated baseline serum sST2 levels were associated with higher unadjusted rates of MACCEs, but this association was attenuated and not statistically significant after multivariable adjustment (adjusted HR 3.28).
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