Role of soluble sST2 Levels in Predicting Major Adverse Cardiovascular Events (MACE) Hospital Readmissions Within 30 Days

Abstract

Introduction: Increased soluble suppression of tumorigenicity 2 (sST2) levels have been shown to predict MACE in patients with acute coronary syndromes (ACS) at 180 days and after 1 year. In this study, we assessed the prognostic value of sST2 levels in predicting hospital readmissions due to MACE within 30 days. Methods and Results: n = 146 patients (mean age: 67 ± 13 yrs) admitted to cardiology unit at John Hunter Hospital for acute coronary syndromes were recruited. sST2 levels were quantitated in plasma, using commercially available ELISA (R&D systems). Occurrences of MACE such as unstable angina/NSTEMI, stroke, recurrent MI, rehospitalisation and death were recorded after 30 days of first admission. Patients with concomitant hypertension, diabetes or dyslipidaemia did not have elevated sST2 levels. Patients with atrial fibrillation (AF) (p < 0.001) or heart failure (p < 0.01) had significantly higher sST2 levels vs. those who did not. On univariate analysis, patients with 30-day MACE (n = 30, 20.5%) tended to have higher sST2 levels vs. those without (p = 0.07). There was a significant correlation between high sST2 levels vs age (β = 0.3, p < 0.001) and CRP (β = 0.5, p < 0.001). On multivariate analysis: 30-day MACE was not associated with high sST2 levels. Older age, high CRP, and presence of AF are associated with elevated sST2 levels. Conclusions: In this patient cohort, elevated sST2 levels were not found to predict 30-day MACE in patients with ACS, but is associated with presence of AF. Larger population studies over longer period of time is required to fully elucidate the prognostic role of sST2 in predicting MACE.