Abstract
A multi-marker approach for assessing the prognosis of patients with ST-segment elevation myocardial infarction (STEMI) is a promising strategy. Aim . To assess the potential prognostic power of soluble growth stimulation gene-2 (sST2), pentraxin 3 (PTX3), and N-terminal pro-brain natriuretic peptide (NT-proBNP) in stratification of the risk of major cardiovascular events (CVE) during 2-year follow-up after STEMI. Material and methods . In 154 patients with STEMI, serum concentrations of NT-proBNP, sST2, and PTx-3 were determined upon admission to hospital. During the two-year follow-up period (734,2±61,2 days), correlation of biomarker concentrations with the risk of a composite endpoint (myocardial infarction + stroke + hospitalization due to cardiovascular disease + cardiovascular death) was analyzed. Results . In the 2-year follow-up, CVE were observed in 81 (55,1%) patients (CV death (n=33; 22,1%), recurrent MI (n=28; 18,.8%), stroke (n=8; 5,4%), hospitalization due to cardiovascular disease other than MI, stroke or cardiovascular death (n=12; 8,2%)). NT-proBNP (HR, 1,19; 95% CI, 1,018-1,32, p<0,001) and sST2 (HR, 1,000013; 95% CI, 1,00-1,001, p=0,007) correlated with CVE in contrast to PTX-3 (HR, 1,178; 95% CI, 0,798-1,73, p=0,434). The most accurate prediction of CVE was shown in the model with three biomarkers (AIC=831, BIC=843, LR=12,45, p=0,033). Conclusion. After STEMI, NT-proBNP and sST2, but not PTX-3, predicted CVE, while 3-marker analysis showed higher accuracy compared to single- and doublemarker.
Highlights
ДИ — доверительный интервал, ЕОК — Европейское общество кардиологов, Инфаркт миокарда (ИМ) — инфаркт миокарда, инфарктом мио карда с подъемом сегмента ST (ИМпST) — инфарктом миокарда с подъемом сегмента ST, КАГ — коронароангиография, остром коронарном синдроме (ОКС) — острый коронарный синдром, острого нарушения мозгового кровообращения (ОНМК) — острое нарушение мозгового кровообращения, ОР — отношение рисков, сердечнососудистых событий (ССС) — сердечно-сосудистые события, фракцией выброса левого желудочка (ФВ ЛЖ) — фракция выброса левого желудочка, факторов риска (ФР) — фактор риска, хронической сердечной недостаточности (ХСН) — хроническая сердечная недостаточность, ЭКГ — электрокардиограмма, FU — follow-up, период наблюдения, LR — отношение правдоподобия, NT-proBNP — N-терминальный пропептид натрийуретического гормона, soluble growth stimulation gene-2 (sST2) — растворимая форма cтимулирующего фактора роста, экспрессируемого геном 2, Ptx-3 — пентраксин 3
In 154 patients with segment elevation myocardial infarction (STEMI), serum concentrations of NT-proBNP, sST2, and PTx-3 were determined upon admission to hospital
The most accurate prediction of cardiovascular events (CVE) was shown in the model with three biomarkers (AIC=831, BIC=843, LR=12,45, p=0,033)
Summary
In 154 patients with STEMI, serum concentrations of NT-proBNP, sST2, and PTx-3 were determined upon admission to hospital. During the two-year follow-up period (734,2±61,2 days), correlation of biomar ker concentrations with the risk of a composite endpoint (myocardial infarction + stroke + hospitalization due to cardiovascular disease + cardiovascular death) was analyzed
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