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可溶性肿瘤抑制物 2 水平对 ST 段抬高型心肌梗死患者主要不良心脏事件无预后意义。

Lack of prognostic significance for major adverse cardiac events of soluble suppression of tumorigenicity 2 levels in patients with ST-segment elevation myocardial infarction.

机构信息

Chungbuk Regional Cardiovascular Center, Chungbuk National University Hospital, Cheongju, Korea, Republic Of.

出版信息

Cardiol J. 2021;28(2):244-254. doi: 10.5603/CJ.a2020.0028. Epub 2020 Feb 27.

DOI:10.5603/CJ.a2020.0028
PMID:32104902
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8078943/
Abstract

BACKGROUND

Elevation of soluble suppression of tumorigenicity 2 (sST2) is associated with cardiac fibrosis and hypertrophy. Under investigation herein, was whether sST2 level is associated with major adverse cardiac events (MACE) and left ventricular (LV) remodeling after primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).

METHODS

In total, this study included 184 patients who underwent successful primary PCI. A subsequent guideline-based medical follow-up was included (61.4 ± 11.8 years old, 85% male, 21% with Killip class ≥ I). sST2 concentration correlations with echocardiographic, angiographic, laboratory parameters, and clinical outcomes in STEMI patients were evaluated.

RESULTS

The median sST2 level was 60.3 ng/mL; 6 (3.2%) deaths occurred within 1 year. The sST2 level correlated with LV ejection fraction (LVEF) changes from baseline to 6 months (r= -0.273; p = 0.006) after adjustment for echocardiographic parameters including wall motions score index (WMSI). Recovery of LVEF at 6 months was highest in the tertile 1 group (Δ6 months - baseline LVEF; tertile 1, p = 0.001; tertile 2, p = 0.319; tertile 3, p = 0.205). The decrease in WMSI at 6 months was greater in the tertiles 1 and 2 groups than in the tertile 3 group (Δ6 months - baseline WMSI; tertile 1, p = 0.001; tertile 2, p = 0.013; tertile 3, p = 0.055). There was no association between sST2 levels and short-term (log rank p = 0.598) and long-term (p = 0.596) MACE.

CONCLUSIONS

sST2 concentration have predictive value for LV remodeling on echocardiography in patients with STEMI who underwent primary PCI. However, sST2 concentration was not associated with short-term and long-term MACE.

摘要

背景

可溶性抑制肿瘤发生 2 (sST2)的升高与心脏纤维化和肥大有关。在此研究中,我们研究了 sST2 水平与急性 ST 段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后主要不良心脏事件(MACE)和左心室(LV)重构的关系。

方法

本研究共纳入 184 例成功接受直接 PCI 的患者。包括随后的基于指南的医学随访(61.4±11.8 岁,85%为男性,21%为 Killip 分级≥I)。评估 sST2 浓度与 STEMI 患者超声心动图、血管造影、实验室参数和临床结局的相关性。

结果

中位 sST2 水平为 60.3ng/ml;1 年内死亡 6 例(3.2%)。sST2 水平与从基线到 6 个月时左心室射血分数(LVEF)的变化相关(校正超声心动图参数后,包括壁运动评分指数(WMSI),r= -0.273;p = 0.006)。在第 1 三分位组中,6 个月时 LVEF 的恢复最高(6 个月时 LVEF 与基线时的差值;第 1 三分位,p = 0.001;第 2 三分位,p = 0.319;第 3 三分位,p = 0.205)。第 1 和第 2 三分位组 6 个月时 WMSI 的下降大于第 3 三分位组(6 个月时 WMSI 与基线时的差值;第 1 三分位,p = 0.001;第 2 三分位,p = 0.013;第 3 三分位,p = 0.055)。sST2 水平与短期(对数秩检验,p = 0.598)和长期(p = 0.596)MACE 之间无相关性。

结论

sST2 浓度对直接 PCI 治疗的 STEMI 患者的超声心动图 LV 重构有预测价值。然而,sST2 浓度与短期和长期 MACE 无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f285/8078943/6db0ac0b46e8/cardj-28-2-244f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f285/8078943/216d7894d042/cardj-28-2-244f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f285/8078943/847210f0de3f/cardj-28-2-244f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f285/8078943/468173446d5c/cardj-28-2-244f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f285/8078943/6db0ac0b46e8/cardj-28-2-244f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f285/8078943/216d7894d042/cardj-28-2-244f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f285/8078943/847210f0de3f/cardj-28-2-244f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f285/8078943/468173446d5c/cardj-28-2-244f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f285/8078943/6db0ac0b46e8/cardj-28-2-244f4.jpg

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