Comparison Between Soluble ST2 and High-Sensitivity Troponin I in Predicting Short-Term Mortality for Patients Presenting to the Emergency Department With Chest Pain.
10.3343/alm.2017.37.2.137
- Author:
Rossella MARINO
1
;
Laura MAGRINI
;
Francesca ORSINI
;
Veronica RUSSO
;
Patrizia CARDELLI
;
Gerardo SALERNO
;
Mina HUR
;
Salvatore DI SOMMA
Author Information
1. Department of Medical-Surgery Sciences and Translational Medicine, University Sapienza Rome, Sant' Andrea Hospital, Rome, Italy. salvatore.disomma@uniroma1.it
- Publication Type:Original Article
- Keywords:
Emergency Department;
Chest pain;
Acute coronary syndrome;
hs-cTnI;
sST2;
30 day mortality;
Prognosis
- MeSH:
Acute Coronary Syndrome/diagnosis/*mortality;
Aged;
Area Under Curve;
Biomarkers/analysis;
Chest Pain;
Emergency Service, Hospital;
Female;
Follow-Up Studies;
Humans;
Interleukin-1 Receptor-Like 1 Protein/*analysis;
Male;
Middle Aged;
Odds Ratio;
Prognosis;
ROC Curve;
Troponin I/*analysis
- From:Annals of Laboratory Medicine
2017;37(2):137-146
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: High-sensitivity cardiac troponin I (hs-cTnI) and the soluble isoform of suppression of tumorigenicity 2 (sST2) are useful prognostic biomarkers in acute coronary syndrome (ACS). The aim of this study was to test the short term prognostic value of sST2 compared with hs-cTnI in patients with chest pain. METHODS: Assays for hs-cTnI and sST2 were performed in 157 patients admitted to the Emergency Department (ED) for chest pain at arrival. In-hospital and 30-day follow-up mortalities were assessed. RESULTS: The incidence of ACS was 37%; 33 patients were diagnosed with ST elevation myocardial infarction (STEMI), and 25 were diagnosed with non-ST elevation myocardial infarction (NSTEMI). Compared with the no acute coronary syndrome (NO ACS) group, the median level of hs-cTnI was higher in ACS patients: 7.22 (5.24-14) pg/mL vs 68 (15.33-163.50) pg/mL (P<0.0001). In all patients, the sST2 level at arrival showed higher independent predictive power than hs-cTnI (odds ratio [OR] 20.13, P<0.0001 and OR 2.61, P<0.0008, respectively). sST2 at ED arrival showed a greater prognostic value for cardiovascular events in STEMI (area under the curve [AUC] 0.80, P<0.001) than NSTEMI patients (AUC 0.72, P<0.05). Overall, 51% of the STEMI patients with an sST2 value>35 ng/mL at ED arrival died during the 30-day follow-up. CONCLUSIONS: sST2 has a greater prognostic value for 30-day cardiac mortality after discharge in patients presenting to the ED for chest pain compared with hs-cTnI. In STEMI patients, an sST2 value >35 ng/mL at ED arrival showed the highest predictive power for short-term mortality.
