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ST2 and mortality i...
ST2 and mortality in non-ST-segment elevation acute coronary syndrome
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- Eggers, Kai M., 1962- (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR),UCR
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Armstrong, Paul W. (author)
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Califf, Robert M. (author)
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Simoons, Maarten L. (author)
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- Venge, Per (author)
- Uppsala universitet,Klinisk kemi
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR),UCR
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- James, Stefan K., 1964- (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR),UCR
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(creator_code:org_t)
- Elsevier BV, 2010
- 2010
- English.
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In: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 159:5, s. 788-794
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- BACKGROUND: ST2 is a member of the interleukin-1 receptor family that is up-regulated in conditions associated with increased myocardial strain. ST2 has been shown to be independently predictive of adverse outcome in heart failure and ST-segment elevation myocardial infarction, but its prognostic value in non-ST-elevation acute coronary syndrome (NSTE-ACS) has not been established. METHODS: We measured ST2 at randomization and after 24, 48, and 72 hours in 403 NSTE-ACS patients from the GUSTO IV study, and studied its kinetics and its associations to clinical baseline factors and 1-year mortality. RESULTS: Median ST2 levels decreased from 28.4 U/mL at randomization to 21.8 U/mL at 72 hours (P < .001). Peak levels were noted 6 to 17 hours after symptom onset. Randomization ST2 levels were independently associated to N-terminal pro-B-type natriuretic peptide but otherwise exhibited only weak relations to cardiovascular risk factors and comorbidities, and biomarkers of myocardial necrosis or inflammation. ST2 was related to 1-year mortality independently of clinical risk indicators (odds ratio 2.3 [95% CI 1.1-4.6], P = .03) but lost its predictive value after additional adjustment for prognostic biomarkers, in particular N-terminal pro-B-type natriuretic peptide. CONCLUSIONS: ST2 levels are elevated early in NSTE-ACS and predict 1-year mortality. Our data indicate that ST2 represents an interesting novel pathophysiologic pathway in the setting of ischemia-related myocardial dysfunction. However, future prospective evaluations in larger populations are needed before the clinical utility of ST2 can be determined.
Keyword
- Aged
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction/*blood/mortality
- Natriuretic Peptide; Brain/*blood
- Patient Admission
- Peptide Fragments/*blood
- Prognosis
- Regression Analysis
- Risk Assessment
- Sensitivity and Specificity
- Survival Analysis
- Troponin T/*blood
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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