Application Of Serum IL-1β Combined With SST2 In Predicting Cardiovascular Mortality In Patients With Acute ST-segment Elevation Myocardial Infarction

Objectives To investigate the value of serum interleukin-1β(IL-1β)combined with soluble suppression of tumorigenicity 2(sST2)in cardiovascular mortality in patients with ST-segment elevation(STEMI).Methods We consecutively enrolled 290 cases with STEMI in our hospital between September 2017 to April 2019.A total of 290 cases were collected for serum IL-1βand sST2 concentrations before coronary angiography(CAG)or percutaneous coronary intervention(PCI)and other clinical data,then they were followed up from the myocardial infarction.The endpoint of the study was cardiovascular mortality.The Kaplan-Meier survival curve analysis was conducted to compare the prognosis of the different group.The COX regression analysis was used to analyze the risk factors of cardiovascular mortality after STEMI by univariate and multivariate analysis.Using the time-dependent receiver operating characteristic(ROC)to study the reliability of IL-1β and sST2 for in-hospital mortality.Results According to the median sST2 concentration(11.24 ng/ml),median IL-1βconcentration(43.72 pg/ml),the patients were classified into four groups: the first group(low IL-1β-low sST2 group),the second group(low IL-1β-high sST2 group),The third group(high IL-1β-low sST2 group)and the fourth group(high IL-1β-high sST2 group).Total 290 patients were received follow up.69 patients(23.7%)were in the first group,and 76 patients(26.1%)were in the second group.78 Patients(26.9%)were in the third group,and 67 patients(23.1%)were in the fourth group.The median follow-up time was 496 days.In-hospital cardiovascular mortality was 17(5.8%).Total Cardiovascular mortality were 23(7.9%).In multivariate COX regression analysis,Female,sST2,and IL-1β remained independent risk factors of cardiovascular mortality after adjusting for age,hemoglobin,and blood glucose.(Female: HR: 5.225,95% CI: 1.397-15.548,P = 0.014;sST2: HR: 1.06,95% CI:1.024-1.097,P = 0.001;IL-1β: HR: 1.013,95% CI: 1.009-1.018,P <0.001).The Kaplan-Meier survival curve suggested that the fourth group had the highest risk of cardiovascular mortality.(Pairwise log-rank fourth group V.S.third group P<0.031,fourth group V.S.second group P <0.045,fourth group V.S.first group P<0.001,respectively).The IL-1β Area under curve(AUC)for the in-hospital mortality was 0.723(95% CI: 0.604-0.864)and the sST2 AUC for the in-hospital mortality was0.747(95% CI: 0.606-0.888).Conclusion IL-1β and sST2 were associated with cardiovascular mortality among patients with STEMI,and the overall cardiovascular survival time were shorted in the high IL-1β-high sST2 group.