Clinical evaluation of plasma soluble suppression of tumotigenicity 2 combined with Gensini score in patients with acute coronary syndrome

Abstract

Objective To evaluate the value of plasma soluble suppression of tumotigenicity 2 (sST2) combined with Gensini score in patients with acute coronary syndrome (ACS). Methods From January to May 2018, 135 patients to be diagnosed with ACS in Xuzhou Central Hospital were selected as the subjects. They were divided into an ACS group (108 cases) and a control group (27 cases) according to their clinical manifestations, electrocardiogram, myocardial necrosis markers and coronary angiography results. Patients in the ACS group were further divided into an unstable angina (UA) group (21 cases), a non-ST-segment elevation myocardial infarction (NSTEMI) group (26 cases) and a ST-segment elevation myocardial infarction (STEMI) group (61 cases). The general data, creatinine, lipoprotein a, high density lipoprotein (HDL), low density lipoprotein (LDL), cystatin, Gensini score, uric acid, neutrophil to lymphocyte ratio (NLR) and sST2 of patients were compared. The predictive values of Gensini score, NLR, sST2, and sST2 combined with Gensini score for ACS patients were analyzed using the receiver operating characteristic (ROC) curve, and the areas under the curve (AUC) were compared using the Z-test. Results There were significant differences in the levels of Gensini score [(66 ± 43) vs. (21 ± 6)], NLR [(4.8 ± 2.8) vs. (2.2 ± 0.8)] and sST2 [(61.2 ± 44.8) mg/L vs. (31.0 ± 8.7) mg/L] between the ACS group and control group (t = 9.385, 6.323, 5.563; all P < 0.001). In addition, the Gensini score [(28 ± 11), (59 ± 23), (82 ± 48)], NLR [(2.3 ± 0.9), (4.6 ± 2.6), (5.7 ± 2.8)] and sST2 [(30.2 ± 1.4) mg/L, (51.5 ± 1.6) mg/L, (72.7 ± 2.1) mg/L] in the UA group, NSTEMI group and STEMI group were significantly different (F = 16.655, 14.678, 7.498; all P < 0.001). Further pairwise comparison showed that the Gensini score, NLR and sST2 in NSTEMI and STEMI groups were all significantly higher than those in the UA group (all P < 0.05). The Gensini score and sST2 in the STEMI group were significantly higher than those in the NSTEMI group (both P < 0.05). The Gensini score, NLR, sST2, and sST2 combined with Gensini score were included in the ROC curve which showed that the Gensini score [AUC = 0.903, 95% confidence interval (CI) (0.874, 0.980)], NLR [AUC = 0.825, 95%CI (0.724, 0.926)], sST2 [AUC = 0.799, 95%CI (0.667, 0.931)], and sST2 combined with Gensini score [AUC = 0.933, 95%CI (0.884, 0.981)] all had predictive values for ACS (all P < 0.001). Furthermore, there were significant differences in AUCs between sST2 combined with Gensini score and Gensini score, NLR, sST2 (Z = 3.783, 5.271, 5.682; P = 0.036, 0.013, 0.004). Conclusion sST2 combined with Gensini score can enhance the predictive value for ACS patients, which is better than using the sST2 or Gensini score alone. Key words: Acute coronary syndrome; Acute myocardial infarction; Soluble suppression of tumotigenicity 2; Gensini score