P-selectin and sST2 as prognostic biomarkers of cardiovascular events in patients with multiple myeloma following anticancer therapy and severe COVID-19

This study investigates the prognostic value of sST2 and P-selectin as biomarkers for cardiovascular risk in patients with multiple myeloma (MM) who are in remission following anticancer therapy and have experienced severe COVID-19. The topic is of increasing clinical relevance due to the growing incidence of cardiovascular complications in this patient population, highlighting the need for reliable tools for early risk stratification. The aim of the study was to assess the prognostic significance of sST2 and P-selectin levels as markers of cardiovascular events in multiple myeloma patients after COVID-19. Materials and methods. The study included 125 patients with MM in partial or complete remission. All participants were followed for 12 months, during which cardiovascular events – including myocardial infarction, stroke, arrhythmias, and heart failure – were recorded. Serum levels of sST2 and P-selectin were measured using ELISA. Results. Cardiovascular events were observed in 29 (27.1 %) patients. Patients who experienced such events had significantly higher median levels of sST2 (48.6 ng/mL vs. 28.6 ng/mL) and P-selectin (74.1 ng/mL vs. 58.05 ng/mL) compared to those without complications (p < 0.05). ROC analysis demonstrated good diagnostic performance, with an AUC of 0.813 for sST2 and 0.737 for P-selectin. A combined biomarker model (sST2 >28.5 ng/mL and P-selectin >67.0 ng/mL) yielded the highest predictive accuracy. Conclusions. Elevated serum levels of sST2 and P-selectin are independent predictors of cardiovascular events in patients with MM after severe COVID-19. These findings support the use of a multi-biomarker approach in cardio-oncohematological monitoring to facilitate the early identification of high-risk patients and personalization of therapeutic strategies.