Prognostic value of the serum st2 levels in patient with NON-ST segment elevation acute coronary syndrome

BACKGROUND: The term acute coronary syndrome refers to any group of clinical symptoms compatible with acute myocardial ischemia and covers the spectrum of clinical conditions ranging from unstable angina (UA) to non ST segment elevation myocardial infarction (NSTEMI) to ST segment elevation myocardial infarction (STEMI). Findings on ECG associated with NSTEMI include ST segment depression, T-wave inversion, or some combination of these factors; depending on the severity of the clinical presentation. These findings are present in 30% to 50% of patients. Measurement of biomarkers is a cornerstone in the assessment of patients with NSTEMI. In particular, biomarkers reflecting myocardial necrosis (eg, troponin I- T and BNP) have demonstrated utility for risk prediction as well as enhancing the selection of patients to suitable therapies. These biomarkers are therefore acknowledged as useful clinical tools. OBJECTIVE: The aim of the present study is to assess plasma concentrations of ST2 in patients who diagnosed as NSTEMI at the emergeny department (ED) and determining the relation between serum ST2 level and 28 day mortalitiy of these patients. METHODS: This prospective, observational, single-center, cross-sectional study was conducted at the ED of Celal Bayar University Hafsa Sultan Hospital. Data was collected from patients who were diagnosed as NSTEMI at the ED according to their examination, ECG and troponin levels. Appropriate patients included to the study and their plasma ST2 leves were determined. All patients were followed up for mortality during 28 days after presentation. RESULTS: A total of 88 patients who diagnosed as NSTEMI were enrolled in this study. These patients followed up 28 days. At the end of this 28 days period, 18 (%20.5) patients died and 70 (%79,5) patients survived. Fifthy patients (%56.8) were male, 38 patients (%43.2) were female. Mean age of survivors were 64.20 ±13.56, non-survivors were 64.28±12.49. Survivor patients mean ST2 level was 651.37±985.66, non-survivor patients mean ST2 level was determined as 2253.66±1721.15, p<0.001. Non-survivors's plasma ST2 level was determined greater than survivors. This situation supports a relation between ST2 level and mortality. ST2 cut off level was found 1000 pg/mL with %72.2 sensitivity, %20.0 specificity, p<0.001. CONCLUSION: According to this study; NSTEMI patients with greater ST2 level at the admittion to the ED, have higher mortality during following 28 days than patients with lower ST2 levels. Thus, ST2 play a further role in the clinical assessment of the severity of NSTEMI.