Prognostic significance of soluble ST2 as predictor of late left ventricular remodeling after ST-segment elevation myocardial infarction

Abstract

The aim — to study the prognostic value of soluble ST2 regarding the development of pathological left ventricular remodeling (LVR) 6 months after acute ST‑ segment elevation myocardial infarction (STEMI)Materials and methods. The study included 65 retrospectively selected patients with STEMI who were hospitalized in the intensive care unit of L. T. Malaya National Institute of Therapy of National Academy of Medical Sciences of Ukraine for the period from January 2016 to June 2018 after myocardial revascularization. All patients had a recovery in TIMI III blood flow. Among the patients, men with a middle age 58.71 ± 11.04 years (83.1 %) prevailed. Ultrasound diagnosis with the determination of the longitudinal strain was conducted. The level of sST2 and N‑terminal cerebral natriuretic peptide was determined by ELISA. Patients were monitored for 6 months. According to the results of the re‑examination, two subgroups were identified, depending on the development of pathological LVR: in the first group, the increase in the endodiastolic LV volume was more than 10 % (n = 29), in the second — less than 10 % (n = 36).Results and discussion. Using ROC‑analysis, it was established that sST2 level > 35 ng/ml during the hospitalization period of STEMI is a predictor of pathological LVR 6 months after successful percutaneous coronary intervention (AUC = 0.672; 95 % confidence interval — 0.523 — 0.799, p = 0.0344, sensitivity — 46.7 %, specificity — 85.7 %). A single and multivariate log‑regression analysis revealed that sST2 > 35 ng/ml was an independent predictor of the development of late LVR.Conclusions. The serum sST2 level of more than 35 ng/ml in patients with STEMI after successful percutaneous coronary intervention with the bloodstream in the infarct‑dependent artery TIMI III is associated with abnormal LVR, which can be used to stratify its risk in this cohort of patients.