Abstract
Introduction Soluble ST2 (sST2) is increased during acute myocardial infarction. The point of care test (POCT) for sST2 is currently available. The aim of this study was to investigate the utility of the sST2 POCT measurement for predicting adverse cardiac events during acute care of ST-elevation myocardial infarction (STEMI). Patients and Methods This research used a cohort study design. Consecutive patients with STEMI were enrolled. Soluble ST2 level was measured from peripheral blood taken on admission with POCT. Observation during acute intensive care was conducted to record adverse cardiac events. Two groups were assigned based on median sST2 level, that is, supramedian and inframedian group. The incidence of adverse cardiac events between groups was analyzed. A p value < 0.05 was statistically significant. Results We analyzed 95 subjects with STEMI and 10 patients with stable coronary artery disease as controls. The median sST2 level was significantly higher in subjects with STEMI as compared to controls (152.1 ng/mL versus 28.5 ng/mL, p < 0.01). Among subjects with STEMI, the supramedian group had higher incidence of adverse cardiac events than the inframedian group (38.3% versus 12.5%, p=0.004). Multivariable analysis showed that supramedian sST2 level was independently associated with increased incidence of adverse cardiac events (adjusted OR 6.27; 95% CI: 1.33–29.47, p=0.020). Conclusions The sST2 POCT measurement was useful to independently predict adverse cardiac events during acute intensive care of STEMI.
Highlights
Soluble ST2 is increased during acute myocardial infarction. e point of care test (POCT) for sST2 is currently available. e aim of this study was to investigate the utility of the sST2 POCT measurement for predicting adverse cardiac events during acute care of ST-elevation myocardial infarction (STEMI)
Acute myocardial infarction with ST-segment elevation (STEMI) is a clinical syndrome which reflects the transmural necrosis of myocardia due to occlusive thrombus in the coronary artery segment. e prevalence of STEMI ranges from 25% to 45% among patients with acute myocardial infarction [1]. e management of STEMI with reperfusion strategies, both fibrinolysis and primary coronary intervention, and pharmacology therapy have successfully reduced the major adverse cardiac events and mortality [1]
Research Design. e research used a cohort study design. e subjects were patients with STEMI admitted to the Intensive Cardiac Care Unit (ICCU) of Dr Sardjito Hospital, Yogyakarta, Indonesia. e subjects were enrolled from the emergency unit of Dr Sardjito Hospital, Yogyakarta, Indonesia, where they were stabilized and subsequently admitted to ICCU. e subjects’ enrollment was conducted by consecutive sampling. e diagnosis of STEMI was determined based on international guidelines, that is, angina symptoms, electrocardiogram criteria, and elevated cardiac enzyme markers [5]. e observations of subjects were conducted during intensive cardiac care in the ICCU
Summary
Soluble ST2 (sST2) is increased during acute myocardial infarction. e point of care test (POCT) for sST2 is currently available. e aim of this study was to investigate the utility of the sST2 POCT measurement for predicting adverse cardiac events during acute care of ST-elevation myocardial infarction (STEMI). E aim of this study was to investigate the utility of the sST2 POCT measurement for predicting adverse cardiac events during acute care of ST-elevation myocardial infarction (STEMI). Among subjects with STEMI, the supramedian group had higher incidence of adverse cardiac events than the inframedian group (38.3% versus 12.5%, p 0.004). E sST2 POCT measurement was useful to independently predict adverse cardiac events during acute intensive care of STEMI. Acute myocardial infarction with ST-segment elevation (STEMI) is a clinical syndrome which reflects the transmural necrosis of myocardia due to occlusive thrombus in the coronary artery segment. The role of biomarkers as a predictor for major adverse cardiac events and mortality in acute hospital care has not been well established. Cardiology Research and Practice among acute coronary syndrome patients It is not considered useful for STEMI [3]. In the initial phase, during which clinical signs and symptoms of left ventricle dysfunction have not yet appeared, the release of sST2 may give an indication of ongoing left ventricle stretching and predict the development of left ventricle dysfunction
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