Role of risk stratification and prognosis of sST2 in acute coronary syndrome patients after percutaneous coronary intervention

doi:10.3969/j.issn.1673-8640.2021.010.007

Abstract

Abstract:

Objective To analyze the role of risk stratification and prognosis of soluble growth stimulating express gene 2（sST2） in patients with acute coronary syndrome（ACS） after percutaneous coronary intervention（PCI）. Methods A total of 285 patients with ACS were enrolled,which included 84 cases of unstable angina（UA）,86 cases of non-ST-segment elevation myocardial infarction（NSTEMI） and 115 cases of ST-segment elevation myocardial infarction（STEMI）. The control group consisted of 80 patients with suspected ACS due to chest pain. All the patients underwent emergency PCI within 12 h of onset. The Gensini scoring system was used to score the degree of vascular lesions. Risk assessment was performed using the Global Registry of Acute Coronary Events（GRACE） scoring system upon admission. The sST2 and other biomarkers were determined. All the patients were followed for 6 months to record whether major adverse cardiovascular events（MACE） occurred or not during the follow-up period. Results The level of serum sST2 in ACS group was higher than that in control group（P<0.001）,and there was statistical significance among UA,NSTEMI and STEMI groups（P<0.05）. The results of binary Logistic regression analysis showed that serum sST2,amino-terminal pro-B-type natriuretic peptide（NT-proBNP）,cardiac troponin I（cTnI）,left ventricular ejection fraction（LVEF） and GRACE score were independent risk factors of MACE in ACS patients [odds ratios（OR） were 1.004,1.019,0.995,0.898 and 1.009]. The results of Kaplan-Meier survival curve showed that ACS patients with low expression of sST2 combined with low GRACE score had the highest overall survival rate,and those with high expression of sST2 combined with high GRACE score had the lowest overall survival rate. Conclusions Serum sST2 level in patients with ACS is related to the severity of myocardial ischemia and necrosis. It at admission is an independent risk factor for MACE in ACS patients. The indicator,sST2,may be a new biomarker for cardiac injury.

Key words: Soluble growth stimulating express gene 2, Acute coronary syndrome, Global Registry of Acute Coronary Events scoring system, Major adverse cardiovascular event

CLC Number:

R446.1

DU Kun, YAN Jianhua, CHEN Ming, YANG Junyao, ZHANG Guanghui. Role of risk stratification and prognosis of sST2 in acute coronary syndrome patients after percutaneous coronary intervention[J]. Laboratory Medicine, 2021, 36(10): 1020-1025.

Figures/Tables 5

References 15

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组别	例数	BMI/ （kg/m²）	高血压史/ [例（%）]		吸烟史/ [例（%）]	饮酒史/ [例（%）]	糖尿病史/ [例（%）]	NT-proBNP/ （pg/mL）
UA组	84	25.2±3.6	48（57.1）		46（54.8）	44（52.4）	33（39.3）	1 457.6±238.53
NSTEMI组	86	24.8±3.4	47（54.6）		49（57.0）	45（52.3）	35（40.7）	1 349.7±194.65
STEMI组	115	26.1±3.5	71（61.7）		70（60.9）	63（54.8）	44（38.2）	1 531.6±227.92
对照组	80	25.3±3.6	26（32.5）		37（46.2）	43（53.7）	13（16.2）	134.4±37.65
统计值		0.384	4.152		12.236	4.539	2.563	7.420
P值		0.317	0.001		0.005	0.211	0.024	<0.001
组别		hs-CRP/ （mg/L）	cTnI/ （ng/mL）		HbA_1c/%	TC/ （mmol/L）	TG/ （mmol/L）	HDL-C/ （mmol/L）
UA组		10.4±3.2	0.09±0.04		7.58±2.34	4.65±0.80	1.63±0.83	1.24±0.42
NSTEMI组		9.6±3.7	1.33±0.42		7.86±2.47	4.67±0.70	1.58±0.81	1.18±0.37
STEMI组		11.2±4.6	1.56±0.52		7.38±2.19	4.78±0.86	1.57±0.76	1.17±0.64
对照组		5.6±4.2	0.015±0.01		5.74±1.43	4.58±0.90	1.53±0.67	1.23±0.53
统计值		9.225	13.218		1.854	1.664	0.783	2.112
P值		<0.001	<0.001		0.023	0.678	0.233	0.885
组别		LDL-C/（mmol/L）		eGFR/[mL（min·1.73 m²）]		LVEF/%	Gensini评分/分	GRACE评分/分
UA组		2.71±0.78		81.57±17.32		56.24±6.83	36.58±6.73	97.78±13.63
NSTEMI组		2.74±0.57		76.84±21.37		51.73±10.2	39.36±9.39	113.47±16.48
STEMI组		2.76±0.69		78.42±18.24		54.38±8.43	46.53±8.23	126.21±12.85
对照组		2.74±0.77		86.32±16.78		61.24±6.22
统计值		2.431		4.157		9.724	8.543	10.231
P值		0.845		0.438		<0.001	0.043	<0.001

组别	例数	BMI/ （kg/m²）	高血压史/ [例（%）]		吸烟史/ [例（%）]	饮酒史/ [例（%）]	糖尿病史/ [例（%）]	NT-proBNP/ （pg/mL）
UA组	84	25.2±3.6	48（57.1）		46（54.8）	44（52.4）	33（39.3）	1 457.6±238.53
NSTEMI组	86	24.8±3.4	47（54.6）		49（57.0）	45（52.3）	35（40.7）	1 349.7±194.65
STEMI组	115	26.1±3.5	71（61.7）		70（60.9）	63（54.8）	44（38.2）	1 531.6±227.92
对照组	80	25.3±3.6	26（32.5）		37（46.2）	43（53.7）	13（16.2）	134.4±37.65
统计值		0.384	4.152		12.236	4.539	2.563	7.420
P值		0.317	0.001		0.005	0.211	0.024	<0.001
组别		hs-CRP/ （mg/L）	cTnI/ （ng/mL）		HbA_1c/%	TC/ （mmol/L）	TG/ （mmol/L）	HDL-C/ （mmol/L）
UA组		10.4±3.2	0.09±0.04		7.58±2.34	4.65±0.80	1.63±0.83	1.24±0.42
NSTEMI组		9.6±3.7	1.33±0.42		7.86±2.47	4.67±0.70	1.58±0.81	1.18±0.37
STEMI组		11.2±4.6	1.56±0.52		7.38±2.19	4.78±0.86	1.57±0.76	1.17±0.64
对照组		5.6±4.2	0.015±0.01		5.74±1.43	4.58±0.90	1.53±0.67	1.23±0.53
统计值		9.225	13.218		1.854	1.664	0.783	2.112
P值		<0.001	<0.001		0.023	0.678	0.233	0.885
组别		LDL-C/（mmol/L）		eGFR/[mL（min·1.73 m²）]		LVEF/%	Gensini评分/分	GRACE评分/分
UA组		2.71±0.78		81.57±17.32		56.24±6.83	36.58±6.73	97.78±13.63
NSTEMI组		2.74±0.57		76.84±21.37		51.73±10.2	39.36±9.39	113.47±16.48
STEMI组		2.76±0.69		78.42±18.24		54.38±8.43	46.53±8.23	126.21±12.85
对照组		2.74±0.77		86.32±16.78		61.24±6.22
统计值		2.431		4.157		9.724	8.543	10.231
P值		0.845		0.438		<0.001	0.043	<0.001

组别	例数	sST2/（ng/mL）
ACS组	285	50.25±5.12^*
UA组	84	48.81±3.67^*
NSTEMI组	86	51.14±4.23^*
STEMI组	115	50.73±4.32^*
对照组	80	19.63±2.58^#△
F值		9.426
P值		<0.001

组别	例数	sST2/（ng/mL）
ACS组	285	50.25±5.12^*
UA组	84	48.81±3.67^*
NSTEMI组	86	51.14±4.23^*
STEMI组	115	50.73±4.32^*
对照组	80	19.63±2.58^#△
F值		9.426
P值		<0.001

变量	β值	标准误	Wald值	OR值（95%CI）	P值
sST2	0.007	0.003	8.439	1.004（1.004~1.011）	<0.001
NT-ProBNP	0.014	0.003	7.885	1.019（1.011~1.022）	0.001
cTnI	0.007	0.003	3.576	0.995（0.958~1.044）	0.034
LVEF	-0.043	0.004	5.304	0.898（0.879~0.966）	0.026
GRACE评分	0.033	0.032	4.677	1.009（0.998~1.025）	0.017
Gensini评分	0.008	0.009	1.984	1.002（0.993~1.056）	0.116