Predicting value of serum soluble ST2 for risk stratification of coronary heart disease and its relationship with cardiac function

Objective To evaluate the predicting value of serum soluble ST2(sST2) level for risk stratification and cardiac function in patients with coronary artery disease(CAD). Methods We included 64 CAD patients of whom 41 had AMI, 15 had unstable angina; 8 non-CAD individuals without significant stenosis on coronary angiography, and 20 outpatients who had prior MI.The clinical data and biochemical markers of the patients were collected.ECG, UCG and SPECT were performed in all patients.CAG was used to evaluate the coronary artery lesions.Serum levels of sST2 were measured by ELISA. Results (1)sST2 levels were significantly increased in patients with AMI as compared to patients with unstable angina group, prior MI group, as well as non-CAD group(all P<0.001), the levels of sST2 were similar between unstable angina group and prior MI group(all P= 0.997). (2)The level of sST2 was negatively correlated with LVEF(r = 0.388, P = 0.029). There was no relationship between sST2 levels and the site of the myocardial infarction as well as the numbers of the occluded vessels(P=0.698, 0.782 ). There was no correlation between emergency thrombolysis and emergency PCI(P=0.14). (3)sST2 level was closely related to the cardiac function, but in ROC analysis, the area under the curve for sST2 was similar with that for NT-ProBNP, an AUC of 0.782 for sST2(95%CI: 0.684-0.880), an AUC of 0.798 for NT-ProBNP(95%CI: 0.708-0.893), correlation analysis showed r=0.388, P<0.001. Conclusions The sST2 has the value of screening for patients who are at high risk of coronary artery disease.It can also help for the risk stratification and predict the activity of disease in CAD patients; The level of sST2 is negatively correlated to the cardiac function, but compared with NT-ProBNP in the evaluation of cardiac function there was no significant advantage. Key words: Coronary artery disease; Soluble ST2; Acute myocardial infarction; Unstable angina