1. Persistently elevated levels of sST2 after acute coronary syndrome are associated with recurrent cardiac events
- Author
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van den Berg, Victor. J., Vroegindewey, Maxime M., Umans, Victor A., van der Harst, Pim, Asselbergs, Folkert W., Akkerhuis, K. Martijn, Kardys, Isabella, Boersma, Eric, Cardiovascular Centre (CVC), and Cardiology
- Subjects
Male ,sST2 ,RISK ,NT-PROBNP ,Health, Toxicology and Mutagenesis ,Clinical Biochemistry ,Middle Aged ,Prognosis ,Interleukin-1 Receptor-Like 1 Protein ,Biochemistry ,C-REACTIVE PROTEIN ,acute coronary syndrome ,SDG 3 - Good Health and Well-being ,MYOCARDIAL-INFARCTION ,MANAGEMENT ,IL-33 ,Humans ,atherosclerosis ,repeated measurements ,SOLUBLE ST2 ,Biomarkers ,secondary prevention ,Proportional Hazards Models - Abstract
Purpose: Higher soluble ST2 (sST2) levels at admission are associated with adverse outcome in acute coronary syndrome (ACS) patients. We studied the dynamics of sST2 over time in post-ACS patients prior to a recurrent ACS or cardiac death. Methods: We used the BIOMArCS case cohort, consisting of 187 patients who underwent serial blood sampling during one-year follow-up post-ACS. sST2 was batch-wise quantified after completion of follow-up in a median of 8 (IQR: 5–11) samples per patient. Joint modelling was used to investigate the association between longitudinally measured sST2 and the endpoint, adjusted for gender, GRACE risk score and history of cardiovascular diseases. Results: Median age was 64 years and 79% were men. The 36 endpoint patients had systematically higher sST2 levels than those that remained endpoint free (mean value 29.6 ng/ml versus 33.7 ng/ml, p-value 0.052). The adjusted hazard ratio for the endpoint per standard deviation increase of sST2 was 1.64 (95% confidence interval: 1.09–2.34; p = 0.019) at any time point. We could not identify a steady or sudden increase of sST2 in the run-up to the combined endpoint. Conclusion: Asymptomatic post-ACS patients with persistently higher sST2 levels are at higher risk of recurrent ACS or cardiac death during one-year follow-up.
- Published
- 2022