Skip to main content

Advertisement

SpringerLink
Log in

Ability of soluble ST2 to predict left ventricular remodeling in patients with acute coronary syndrome

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

The association of the soluble suppression of tumorigenicity 2 (sST2) and the prognosis of heart failure have been well evaluated. However, little is known about the prediction of sST2 for left ventricular (LV) remodeling in acute coronary syndrome (ACS). We investigated the ability of sST2 to predict LV remodeling following the revascularization of ACS. From May 2019 to December 2020, 95 patients with LV ejection fraction (EF) < 50% who underwent coronary revascularization for ACS (unstable angina, non-ST-elevation myocardial infarction, ST-elevation myocardial infarction) were enrolled. Echocardiography and sST2 were performed at baseline and at a 3-month follow-up. The association between LV remodeling, using the end-diastolic volume index, and sST2 at baseline and at the 3-month follow-up, and the difference between each value was explored. During follow-up, 41 patients showed LV adverse remodeling. The baseline sST2 increased in patients without adverse remodeling (32.05 ng/mL vs. 23.5 ng/mL, p < 0.001), although clinical characteristics were similar between the two groups. During the mean follow-up of 3 months, a significant correlation was found in the changes between sST2 and LV end-diastolic/systolic volume index (r = 0.649; p < 0.001, r = 0.618; p < 0.001, respectively), but not in the changes of LVEF (r = − 0.132, p = 0.204). The use of angiotensin-converting enzyme 2 inhibitors/receptor blockers was higher (90.7% vs. 53.7%, p < 0.001) and sST2 decreased more predominantly in patients without adverse remodeling (23.18 ng/mL vs 26.40 ng/mL, p = 0.003). However, the changes in sST2 and LV volume were not different according to the ACS types (p > 0.05, for all). Estimates of the odds ratio (OR) for remodeling according to the sST2 difference increased substantially with a negative increase in the sST2 difference. Multivariable analysis found that, the difference between the baseline and 3-month sST2 was the most important determinant of LV remodeling following the revascularization of ACS (OR 1.24; 95% confidence interval: 1.09 to 1.41; p = 0.001). In conclusion, an increase in sST2 during follow-up was a useful predictor of LV remodeling.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Aimo A, Januzzi JL, Bayes-Genis A, Vergaro G, Sciarrone P, Passino C, Emdin M (2019) Clinical and prognostic significance of sST2 in heart failure: JACC review topic of the week. J Am Coll Cardiol 74:2193–2203

    Article  CAS  Google Scholar 

  2. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, Drazner MH, Filippatos GS, Fonarow GC, Givertz MM, Hollenberg SM, Lindenfeld J, Masoudi FA, McBride PE, Peterson PN, Stevenson LW, Westlake C (2017) 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Am Coll Cardiol 70:776–803

    Article  Google Scholar 

  3. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL (2013) 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 128:1810–1852

    Article  Google Scholar 

  4. Kakkar R, Lee RT (2008) The IL-33/ST2 pathway: therapeutic target and novel biomarker. Nat Rev Drug Discov 7:827–840

    Article  CAS  Google Scholar 

  5. Ky B, French B, McCloskey K, Rame JE, McIntosh E, Shahi P, Dries DL, Tang WH, Wu AH, Fang JC, Boxer R, Sweitzer NK, Levy WC, Goldberg LR, Jessup M, Cappola TP (2011) High-sensitivity ST2 for prediction of adverse outcomes in chronic heart failure. Circ Heart Fail 4:180–187

    Article  Google Scholar 

  6. Dieplinger B, Januzzi JL Jr, Steinmair M, Gabriel C, Poelz W, Haltmayer M, Mueller T (2009) Analytical and clinical evaluation of a novel high-sensitivity assay for measurement of soluble ST2 in human plasma–the presage ST2 assay. Clin Chim Acta 409:33–40

    Article  CAS  Google Scholar 

  7. Baur LH, Schipperheyn JJ, van der Wall EE, van der Velde EA, Schalij MJ, van Eck-Smit BL, van der Laarse A, Voogd PJ, Sedney MI, Reiber JH, Bruschke AV (1997) Beneficial effect of enalapril on left ventricular remodelling in patients with a severe residual stenosis after acute anterior wall infarction. Eur Heart J 18:1313–1321

    Article  CAS  Google Scholar 

  8. Kercheva M, Ryabova T, Gusakova A, Suslova TE, Ryabov V, Karpov RS (2019) Serum soluble ST2 and adverse left ventricular remodeling in patients with st-segment elevation myocardial infarction. Clin Med Insights Cardiol 13:1179546819842804

    Article  Google Scholar 

  9. Iwahana H, Yanagisawa K, Ito-Kosaka A, Kuroiwa K, Tago K, Komatsu N, Katashima R, Itakura M, Tominaga S (1999) Different promoter usage and multiple transcription initiation sites of the interleukin-1 receptor-related human ST2 gene in UT-7 and TM12 cells. Eur J Biochem 264:397–406

    Article  CAS  Google Scholar 

  10. Ciccone MM, Cortese F, Gesualdo M, Riccardi R, Di Nunzio D, Moncelli M, Iacoviello M, Scicchitano P (2013) A novel cardiac bio-marker: ST2: a review. Molecules 18:15314–15328

    Article  CAS  Google Scholar 

  11. Sanada S, Hakuno D, Higgins LJ, Schreiter ER, McKenzie AN, Lee RT (2007) IL-33 and ST2 comprise a critical biomechanically induced and cardioprotective signaling system. J Clin Invest 117:1538–1549

    Article  CAS  Google Scholar 

  12. Dattagupta A, Immaneni S (2018) ST2: current status. Indian Heart J 70:S96–S101

    Article  Google Scholar 

  13. Pascual-Figal DA, Lax A, Perez-Martinez MT, del Carmen A-L, Sanchez-Mas J, Network GREAT (2016) Clinical relevance of sST2 in cardiac diseases. Clin Chem Lab Med 54:29–35

    Article  CAS  Google Scholar 

  14. Asensio-Lopez MC, Lax A, Fernandez del Palacio MJ, Sassi Y, Hajjar RJ, Januzzi JL, Bayes-Genis A, Pascual-Figal DA (2019) Yin-Yang 1 transcription factor modulates ST2 expression during adverse cardiac remodeling post-myocardial infarction. J Mol Cell Cardiol 130:216–233

    Article  CAS  Google Scholar 

  15. Petyunina VO, Kopytsya PM, Berezin AE (2018) Elevated levels of circulating soluble ST2 at discharge predict late adverse ventricular remodeling in patients with ST-segment elevation myocardial infarction. Biomed Res Ther 5:2863–2875

    Article  Google Scholar 

  16. Bière L, Garcia G, Guillou S, Larcher F, Furber A, Willoteaux S, Mirebeau-Prunier D, Prunier F (2018) ST2 as a predictor of late ventricular remodeling after myocardial infarction. Int J Cardiol 259:40–42

    Article  Google Scholar 

  17. Aleksova A, Paldino A, Beltrami AP, Padoan L, Iacoviello M, Sinagra G, Emdin M, Maisel AS (2019) Cardiac biomarkers in the emergency department: the role of soluble ST2 (sST2) in acute heart failure and acute coronary syndrome-there is meat on the bone. J Clin Med 8:270

    Article  CAS  Google Scholar 

  18. Miñana G, Núñez J, Bayés-Genís A, Revuelta-López E, Ríos-Navarro C, Núñez E, Chorro FJ, López-Lereu MP, Monmeneu JV, Lupón J, Bodí V (2018) ST2 and left ventricular remodeling after ST-segment elevation myocardial infarction: a cardiac magnetic resonance study. Int J Cardiol 270:336–342

    Article  Google Scholar 

  19. MacIver DH (2010) Is remodeling the dominant compensatory mechanism in both chronic heart failure with preserved and reduced left ventricular ejection fraction? Basic Res Cardiol 105:227–234

    Article  Google Scholar 

  20. Fabijanovic D, Milicic D, Cikes M (2019) Left ventricular size and ejection fraction: are they still relevant? Heart Fail Clin 15:147–158

    Article  Google Scholar 

  21. Mele D, Nardozza M, Ferrari R (2018) Left ventricular ejection fraction and heart failure: an indissoluble marriage? Eur J Heart Fail 20:427–430

    Article  Google Scholar 

  22. Sánchez-Más J, Lax A, Asensio-López Mdel C, Fernandez-Del Palacio MJ, Caballero L, Santarelli G, Januzzi JL, Pascual-Figal DA (2014) Modulation of IL-33/ST2 system in postinfarction heart failure: correlation with cardiac remodelling markers. Eur J Clin Invest 44:643–651

    Article  Google Scholar 

  23. Kohli P, Bonaca MP, Kakkar R, Kudinova AY, Scirica BM, Sabatine MS, Murphy SA, Braunwald E, Lee RT, Morrow DA (2012) Role of ST2 in non-ST-elevation acute coronary syndrome in the MERLIN-TIMI 36 trial. Clin Chem 58:257–266

    Article  CAS  Google Scholar 

  24. Huang G, Zhai J, Huang X, Zheng D (2018) Predictive value of soluble ST-2 for changes of cardiac function and structure in breast cancer patients receiving chemotherapy. Medicine (Baltimore) 97:e12447

    Article  Google Scholar 

  25. Nougué H, Pezel T, Picard F, Sadoune M, Arrigo M, Beauvais F, Launay JM, Cohen-Solal A, Vodovar N, Logeart D (2019) Effects of sacubitril/valsartan on neprilysin targets and the metabolism of natriuretic peptides in chronic heart failure: a mechanistic clinical study. Eur J Heart Fail 21:598–605

    Article  Google Scholar 

  26. Zile MR, O’Meara E, Claggett B, Prescott MF, Solomon SD, Swedberg K, Packer M, McMurray JJV, Shi V, Lefkowitz M, Rouleau J (2019) Effects of sacubitril/valsartan on biomarkers of extracellular matrix regulation in patients with HFrEF. J Am Coll Cardiol 73:795–806

    Article  CAS  Google Scholar 

  27. Vianello E, Dozio E, Tacchini L, Frati L, Corsi Romanelli MM (2019) ST2/IL-33 signaling in cardiac fibrosis. Int J Biochem Cell Biol 116:105619

    Article  CAS  Google Scholar 

  28. Bolognese L, Neskovic AN, Parodi G, Cerisano G, Buonamici P, Santoro GM, Antoniucci D (2002) Left ventricular remodeling after primary coronary angioplasty: patterns of left ventricular dilation and long-term prognostic implications. Circulation 106:2351–2357

    Article  Google Scholar 

  29. Bulluck H, Go YY, Crimi G, Ludman AJ, Rosmini S, Abdel-Gadir A, Bhuva AN, Treibel TA, Fontana M, Pica S, Raineri C, Sirker A, Herrey AS, Manisty C, Groves A, Moon JC, Hausenloy DJ (2017) Defining left ventricular remodeling following acute ST-segment elevation myocardial infarction using cardiovascular magnetic resonance. J Cardiovasc Magn Reson 19:26

    Article  Google Scholar 

  30. Bière L, Donal E, Jacquier A, Croisille P, Genée O, Christiaens L, Prunier F, Gueret P, Boyer L, Furber A (2016) A new look at left ventricular remodeling definition by cardiac imaging. Int J Cardiol 209:17–19

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by the research promoting grant from the Keimyung University Dongsan Medical Center in Korea. The authors would like to also acknowledge J-H Jeon, RN and S-Y Kim, RN for their significant contribution to this study.

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, 1035 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea

    Sohyeon Park, In-Cheol Kim, Hyungseop Kim, Yun-Kyeong Cho, Cheol Hyun Lee & Seung-Ho Hur

Authors
  1. Sohyeon Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. In-Cheol Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hyungseop Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yun-Kyeong Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cheol Hyun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Seung-Ho Hur
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hyungseop Kim.

Ethics declarations

Conflict of interest

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, S., Kim, IC., Kim, H. et al. Ability of soluble ST2 to predict left ventricular remodeling in patients with acute coronary syndrome. Heart Vessels 37, 173–183 (2022). https://doi.org/10.1007/s00380-021-01905-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-021-01905-z

Keywords

Search

Navigation