The Value of Soluble ST2 in Predicting Cardiorenal Syndrome Type 1 in Acute Myocardial Infarction Patients.

Abstract

To investigate the predictive value of soluble growth stimulation expressed gene 2 (sST2) for the development of Cardiorenal syndrome type 1 (CRS1) in patients with acute myocardial infarction during hospitalization. A retrospective study included 202 patients with acute myocardial infarction, divided into the CRS1 group (n = 61) and the Non-CRS1 group (n = 141) by the CRS1 occurrence. A logistic regression analysis was applied to find independent predictors of the CRS1 occurrence during hospitalization. Receiver operating characteristic (ROC) curves were applied to analyze the predictive values of sST2, N-terminal pro-B type natriuretic peptide (NT-proBNP), and estimated glomerular filtration rate (eGFR). The multivariate logistic regression analysis revealed that sST2, NT-proBNP, eGFR, Multivessel coronary artery disease, and diuretic use were independent predictors of the CRS1 occurrence during hospitalization. Application of ROC curve analysis displayed that sST2 had the largest area under the curve (AUC) value of 0.874, sensitivity of 0.770, and specificity of 0.894; sST2, eGFR, and NT-proBNP as combined predictors had an AUC value of 0.908, sensitivity of 0.820, and specificity of 0.908. The ROC curves of sST2 and the combined predictive indices were compared using MedCalc software (version 19.6.3), and no statistically significant difference was found between the two (p = 0.142). The cutoff values of the three indicators were determined by the maximum Youden index. When sST2 ≥61.8 ng/mL, eGFR ≤80.6 mL/min/1.73 m2 and NT-proBNP ≥1525 pg/mL were classified as abnormal range, it was found that more number of abnormal indicators may be more advantageous of risk stratification in CRS1. sST2 can be used as a novel predictor of the CRS1 occurrence in patients with acute myocardial infarction during hospitalization. sST2, eGFR, and NT-proBNP combined may have better predictive value.