Luo Guqing, Qian Yuxuan, Sheng Xincheng, Sun Jiateng, Wu Zhinan, Liao Fei, Feng Qi, Yin Yan, Ding Song, Pu Jun
Department of Cardiology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.
Department of Radiology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China.
Front Cardiovasc Med. 2021 Jul 22;8:688522. doi: 10.3389/fcvm.2021.688522. eCollection 2021.
Recent studies have suggested that soluble suppression of tumorigenicity-2 (sST2), an inflammation-related protein receptor, is associated with atherosclerotic diseases. This study aimed to investigate the potential predictive value of sST2 on plaque vulnerability by assessing whether elevated serum levels of sST2 are associated with vulnerable plaque features in patients with non-ST-elevation acute coronary syndrome (ACS). A total of 120 patients with non-ST-elevation ACS (167 lesions) were prospectively enrolled and evaluated by standard coronary computed tomography angiography (CCTA) and coronary angiography in this study. Serum sST2 levels were measured by ELISA (Presage ST2 Assay Kit, Critical Diagnostics), and semiautomated software (QAngioCT, Medis) was used to quantify coronary plaques. The included patients were divided into 4 groups by serum sST2 level quartiles. Volumetric analysis of the whole lesion revealed that patients with higher sST2 levels had a larger absolute necrotic core (NC) volume (Quartile 4 vs. Quartile 1, 86.16 ± 59.71 vs. 45.10 ± 45.80 mm, = 0.001; Quartile 4 vs. Quartile 2, 86.16 ± 59.71 vs. 50.22 ± 42.56 mm, = 0.002) and a higher NC percentage (Quartile 4 vs. Quartile 1, 35.16 ± 9.82 vs. 23.21 ± 16.18%, < 0.001; Quartile 4 vs. Quartile 2, 35.16 ± 9.82% vs. 22.50 ± 14.03%, < 0.001; Quartile 4 vs. Quartile 3, 35.16 ± 9.82% vs. 25.04 ± 14.48%, < 0.001). Correlation analysis revealed that serum sST2 levels were positively correlated with the NC ( = 0.323, < 0.001) but negatively correlated with dense calcium ( = -0.208, = 0.007). Furthermore, among those with plaque calcification, patients with spotty calcification exhibited higher serum sST2 levels than those with large calcification (26.06 ± 16.54 vs. 17.55 ± 7.65 ng/mL, = 0.002). No significant differences in plaque components at the level of the minimal lumen area (MLA) were found among the groups. Serum sST2 levels were correlated with different coronary plaque components in patients with non-ST-elevation ACS. A higher serum level of sST2 was correlated with plaque vulnerability. www.ClinicalTrials.gov, identifier: NCT04797819.
近期研究表明，可溶性致瘤性抑制因子2（sST2）是一种炎症相关蛋白受体，与动脉粥样硬化性疾病有关。本研究旨在通过评估非ST段抬高型急性冠状动脉综合征（ACS）患者血清sST2水平升高是否与易损斑块特征相关，来探讨sST2对斑块易损性的潜在预测价值。本研究前瞻性纳入了120例非ST段抬高型ACS患者（167个病变），并通过标准冠状动脉计算机断层扫描血管造影（CCTA）和冠状动脉造影进行评估。采用酶联免疫吸附测定法（Presage ST2检测试剂盒，Critical Diagnostics）测定血清sST2水平，并使用半自动软件（QAngioCT，Medis）对冠状动脉斑块进行定量分析。根据血清sST2水平四分位数将纳入患者分为4组。对整个病变的容积分析显示，sST2水平较高的患者有更大的绝对坏死核心（NC）容积（四分位数4组与四分位数1组相比，86.16±59.71对45.10±45.80mm，P = 0.001；四分位数4组与四分位数2组相比，86.16±59.71对50.22±42.56mm，P = 0.002）和更高的NC百分比（四分位数4组与四分位数1组相比，35.16±9.82对23.21±16.18%，P < 0.001；四分位数4组与四分位数2组相比，35.16±9.82%对22.50±14.03%，P < 0.001；四分位数4组与四分位数3组相比，35.16±9.82%对25.04±14.48%，P < 0.001）。相关性分析显示，血清sST2水平与NC呈正相关（r = 0.323，P < 0.001），但与致密钙呈负相关（r = -0.208，P = 0.007）。此外，在有斑块钙化的患者中,斑点状钙化患者的血清sST2水平高于大块钙化患者（26.06±16.54对17.55±7.65 ng/mL，P = 0.002）。各组间最小管腔面积（MLA）水平的斑块成分无显著差异。非ST段抬高型ACS患者血清sST2水平与不同冠状动脉斑块成分相关。较高的血清sST2水平与斑块易损性相关。ClinicalTrials.gov，标识符：NCT04797819。
