Abstract
Background Elevated sera soluble (s)ST2 levels are an emerging novel biomarker in the clinic used to predict mortality from acute and chronic heart failure, and have been found to predict heart failure from biopsy-proven and clinically suspected myocarditis based on New York Heart Association (NYHA) class, particularly in men under age 50. Objective Here we investigated whether sera sST2 levels differed according to sex and age for several cardiovascular conditions. Methods Adults with myocardial infarction (MI) (n=151), cardiomyopathy (a general category, not clinically suspected myocarditis per se) (n=293), congestive heart failure (CHF) (n=286), and coronary artery disease (CAD) (n=239), were identified from the Mayo Clinic Biobank. Sera sST2 levels were examined using the FDA approved Critical Diagnostics sST2 ELISA kit. Results Sera sST2 levels were significantly higher in men with MI (p=0.03) and cardiomyopathy (p=0.004) compared to women, but not CHF or CAD. The sex difference was observed in men over age 50 for MI (p=0.01) and cardiomyopathy (p=0.0075). Women with MI under age 50 had significantly higher levels of sST2 than women over age 50 (p=0.001). Previously, we reported that sST2 levels were increased in biopsy-proven or clinically suspected myocarditis patients with NYHA class III-IV heart failure for both sexes (p=0.005, p=0.002, respectively), with a strong correlation in men (p=0.0003, p Conclusion We found in this study that older, male patients with MI or cardiomyopathy had elevated sera sST2 levels. We showed previously that sST2 levels are elevated in the sera of men under the age of 50 in biopsy-confirmed and clinically suspected myocarditis patients, which represents the ‘acute’ stage of the disease. In contrast MI and cardiomyopathy/dilated cardiomyopathy typically occur after age 50, which coincides with the observation of elevated sera sST2 in these conditions after age 50 in this study. The findings of this study highlight the importance of examining inflammatory cardiovascular biomarkers like sST2 according to sex and age.
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