Key result
Baseline sST2 is not associated with 1-year MACE in STEMI patients undergoing primary PCI.
Why the study?
Elevation of sST2 is associated with cardiac fibrosis and hypertrophy, but whether sST2 levels associate with MACE and LV remodeling after primary PCI in acute STEMI was unclear.
Does sST2 level predict major adverse cardiac events and left ventricular remodeling in patients with STEMI after primary PCI?
Observational (n=184)
No
Does sST2 level predict major adverse cardiac events and left ventricular remodeling in patients with STEMI after primary PCI?
Hazard Ratio: 0.99 (95% CI 0.95–1.02)
p-value: p=0.439
In STEMI patients undergoing primary PCI, sST2 levels predict left ventricular remodeling at 6 months but are not associated with short- or long-term major adverse cardiac events.
No support for sST2 in post-STEMI MACE risk stratification; leaves open remodeling prediction.
BACKGROUND: Elevation of soluble suppression of tumorigenicity 2 (sST2) is associated with cardiac fibrosis and hypertrophy. Under investigation herein, was whether sST2 level is associated with major adverse cardiac events (MACE) and left ventricular (LV) remodeling after primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). METHODS: In total, this study included 184 patients who underwent successful primary PCI. A subsequent guideline-based medical follow-up was included (61.4 ± 11.8 years old, 85% male, 21% with Killip class ≥ I). sST2 concentration correlations with echocardiographic, angiographic, laboratory parameters, and clinical outcomes in STEMI patients were evaluated. RESULTS: The median sST2 level was 60.3 ng/mL; 6 (3.2%) deaths occurred within 1 year. The sST2 level correlated with LV ejection fraction (LVEF) changes from baseline to 6 months (r= -0.273; p = 0.006) after adjustment for echocardiographic parameters including wall motions score index (WMSI). Recovery of LVEF at 6 months was highest in the tertile 1 group (Δ6 months - baseline LVEF; tertile 1, p = 0.001; tertile 2, p = 0.319; tertile 3, p = 0.205). The decrease in WMSI at 6 months was greater in the tertiles 1 and 2 groups than in the tertile 3 group (Δ6 months - baseline WMSI; tertile 1, p = 0.001; tertile 2, p = 0.013; tertile 3, p = 0.055). There was no association between sST2 levels and short-term (log rank p = 0.598) and long-term (p = 0.596) MACE. CONCLUSIONS: sST2 concentration have predictive value for LV remodeling on echocardiography in patients with STEMI who underwent primary PCI. However, sST2 concentration was not associated with short-term and long-term MACE.
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Kim et al. (2020) conducted an observational in ST-segment elevation myocardial infarction (n=184). Soluble suppression of tumorigenicity 2 (sST2) levels vs. Lower sST2 levels was evaluated on Major adverse cardiac events (MACE) at 1 year (HR 0.99, 95% CI 0.95-1.02, p=0.439). Baseline sST2 concentration was not significantly associated with 1-year major adverse cardiac events (HR 0.99) in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
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