The Role of Human Suppression of Tumorigenicity 2 (ST2) in Predicting the Clinical Outcome and Mortality in Patients with ST Elevation Myocardial Infarction,
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- Category: Vol. 84, March 2016
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The Role of Human Suppression of Tumorigenicity 2 (ST2) in Predicting the Clinical Outcome and Mortality in Patients with ST Elevation Myocardial Infarction, NEAMA ALI, MOHAMED ABD EL-SHAFY, KHALED EMAD EL-DIN and DALIA AWARA
Abstract
Introduction: Acute myocardial infarction is the leading cause of death and a person having an acute myocardial infarction usually has sudden chest pain, shortness of breath, sweating, nausea, vomiting, abnormal heartbeats, and anxiety, but it may be asymptomatic. (1) The main ways for diagnosis are ECGs and blood tests a CK-MB and troponin. Soluble Human Suppression of Tumorigenicity 2 (ST2) is a novel biomarker in inflammatory conditions and cardiovascular disease, and it plays a role in ventricular remodeling and Heart Failure (HF) progression. In patients with HF, ST2 is strongly associated with both disease severity and mortality.
Aim of Study: To study the role of serum level of ST2 in ST elevation myocardial infarction, and its relation to clinical outcome and mortality.
Methods: Samples were collected from 60 patients who developed ST segment elevation myocardial infarction, patients were followed-up during ICU stay till discharge and then were evaluated after one month for the detection of CHF, Recurrent MI, (by history taking and echocardiography), or death.
Results: In our study we found that there was a highly significant relationship between ST2 and the development of CHF and death with p-value <0.05 and 0.001 respectively, Also we found a significant relationship between ST2 level and need of vasopressors and MV with p-value <0. 05. Clinical follow-up after 30 days show a significant relationship between ST2 and the development of CHF and death after 30 days with p-value 0.001, 0.01 respectively. In echocardiography we found that there was a highly significant relationship between ST2 and EF, LVED and LVES with p-value <0.05, and also we found a highly significant relationship bet ST2 level and echo findings after 30 days (EF 30, LVED 30, LVES 30) with p-value <0.05. As regard relation between ST2 and risk factors, we found that there was significant relationship between ST2 and history of previous MI with p-value 0.021, and an insignificant relationship with other risk factors. As regard vital signs, we found that there was significant rela-tionship between ST2 and the HR, systolic and diastolic BP p-value 0.001, p-value 0.012 and 0.004 respectively, and a highly significant relationship between ST2 and KILLIP score p-value <0.05, also we found a significant relationship between ST2 and CPK with p-value 0.01. We compared ST2 level and the management protocol and we found a non significant relationship between ST2 level and the management protocol used where p-value was 0.40 with PCI and was 0.272 with streptokinase.
Conclusion: Serum level of ST2 a family member of interleukin 1 receptor can predict mortality and heart failure in patients presented with STEMI, and may aid in clinical decision making.