Could sST2 Predict Contrast-Induced Nephropathy in ST-Segment Elevation Myocardial Infarction?

Ahmet Avcı,1 Mustafa Umut Somuncu,1 Murat Can,2 Ferit Akgul1 1Department of Cardiology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey; 2Department of Biochemistry, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, TurkeyCorrespondence: Ahmet AvcıDepartment of Cardiology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Bülent Ecevit Universitesi Tip Fakultesi Dekanligi Ibn-i Sina Kampusu, Esenköy/Kozlu, Zonguldak 67600, TurkeyTel +90 505 548 2710Email drahmetavci@yahoo.comBackground and Aim: One of the most worrying complications of primary percutaneous coronary interventions is contrast-induced nephropathy (CIN) that is associated with increased mortality and morbidity in myocardial infarction. In this study, we questioned whether soluble suppression of tumorigenesis-2 (sST2), which has thought to play a role in inflammatory processes, cardiac remodeling, and fibrosis could give an idea about the development of CIN in ST-elevation myocardial infarction (STEMI) patients.Patients and Methods: This study is a cross-sectional observational study and includes 357 consecutive STEMI patients. Demographic features, medical history, laboratory parameters, and procedural characteristics were compared according to CIN’s development. The multivariate logistic regression analysis was selected to detect independent risk factors of CIN.Results: In the study, 81 patients (22.7%) who developed CIN were identified. The concentration of sST2 in CIN (+) group was higher than that of CIN (-) group (40.6± 21.0 ng/mL vs 31.5± 13.0 ng/L, p< 0.001). Independent predictors of CIN development were diabetes mellitus (OR, 2.059; 95% CI, 1.093– 3.879; p=0.025), eGFR (OR, 0.983; 95% CI, 0.972– 0.995; p=0.006), lower systolic blood pressure (OR, 0.976; 95% CI, 0.960– 0.993; p=0.006), total procedure time (OR, 1.030; 95% CI, 1.011– 1.049; p=0.002), and sST2 (OR, 1.101; 95% CI; 1.046– 1.160; p< 0.001). Besides, the risk of developing CIN in the high sST2 group is 3.06 times higher than the low group sST2 group regardless of other risk factors.Conclusion: sST2 levels on admission in STEMI patients are useful in predicting CIN development.Keywords: contrast-induced nephropathy, soluble ST2, ST-elevation myocardial infarction, primary percutaneous coronary intervention