Preliminary Study On The Clinical Significance Of Blood ST2 Concentration In Acute Coronary Syndrome

Objective:The aim of this study was investigated whether serum ST2 concentration can be a useful novel biomarker for predicting acute coronary syndrome.Methods:A total of 185 patients who underwent selective coronary angiography(CAG)in the Department of Cardiology of XX Hospital from August 2020 to January 2021 were collected.After screening,165 patients were selected from the control group(n=67),unstable angina pectoris group(UA;n =31),acute myocardial infarction group(AMI;n=67),and there were 67 patients in the control group.Patients without significant coronary artery stenosis were selected.General clinical data,including gender,age,weight,height,body mass index(BMI),smoking history,alcohol consumption history,and medication histories(including use of angiotensin convertingenzyme inhibitors(ACEIs),Angiotensin receptor blocks(ARBs),β-receptor blockers and other drugs),previous cardiocerebrovascular diseases(hypertension,diabetes,stroke,coronary artery bypass graft,atrial fibrillation),etc.Biochemical indexes and auxiliary examinations were collected,including myocardial infarction,liver function,blood lipid,renal function,growth stimulation expressed gene 2(ST2),B type natriuretic peptide(BNP),high-sensitive C-reactive protein(hs-CRP),glycosylated hemoglobin(Hb A1C),myocardial enzyme,color doppler echocardiography,etc.Gensini scores were calculated according to the stenosis of coronary arteries.Statistical analysis was conducted to observe the changes of serum ST2 expression levels in the three groups(Control group,Unstable angina group and Acute myocardial infarction group),then observe which clinical indicators are closely related to serum ST2,and finally observe the prediction and diagnostic value of serum ST2 in acute coronary syndrome.Results:1.Comparison of general clinical data of the three groups: gender,smoking history,drinking history,ACEI/ARB and β-blocker drug use in the acute myocardial infarction group were higher than those in the control group and unstable angina group,and the differences were statistically significant(P < 0.05)(Table 1).2.Comparison of biochemical indexes and auxiliary examination among the three groups: the ST2,c Tn I,CK,CK-MB,BNP,Hs-CRP,LDH,AST and Gensini scores in the acute myocardial infarction group were significantly higher than those in the control group and the unstable angina group,LVEF and LVFS were significantly lower than those of control group and unstable angina group,the difference was statistically significant(P < 0.05)(Table 2).3.Comparison of serum ST2 concentration expression levels among the three groups showed that the expression level of ST2 in the acute myocardial infarction group was significantly higher than that in the control group and the unstable angina group,while there was no significant difference between the control group and the unstable angina group(Figure 1).4.Unit regression analysis was performed between the statistically significant clinical indicators in Table 2 and serum ST2 concentration in the acute myocardial infarction group,among which there were statistically significant differences in CK,CK-MB,BNP,Hs-CRP,AST,LDH,LVEF,LVFS and Gensini scores(P < 0.05)(Table3).5.Multiple regression analysis was conducted between the overall clinical indicators with statistically significant significance in Table 3 and serum ST2 concentration in the acute myocardial infarction group,and there were statistically significant differences in CK,CK-MB,BNP,HS-CRP,LVEF and Gensini scores(P <0.05)(Table 4).6.Correlation analysis was conducted between the statistically significant clinical indicators in Table 4 and serum ST2 concentration in the acute myocardial infarction group.The results showed that BNP,CK-MB,CK,Hs-CRP and Gensini scores were significantly positively correlated with the increase of serum ST2 concentration,while LVEF was significantly negatively correlated.The difference was statistically significant(P < 0.001)(Figure 2-7).7.ROC curve analysis results of serum ST2 concentration for prediction and diagnosis of acute myocardial infarction showed that the area under the curve was0.835(95%CI: 0.700-0.900),the Jorden index was 0.561,the best critical value is23.705,the sensitivity was 94.9%,and the specificity was 61.2%(Figure 8).Serum ST2 concentration has certain predictive and diagnostic value for acute myocardial infarction.Conclusions:The serum ST2 concentration was correlated with the changes such as the traditional myocardial necrosis and cardiac function related indexes(BNP,CK-MB,CK,hs-CRP,LVEF and Gensini scores),suggesting that it could be a novel potential biomarker for predicting acute myocardial infarction and cardiac dysfunction,however,there is no change in unstable angina pectoris,and further clinical validation is needed.