Correlation of Suppression of Tumourigenicity 2 with hsCRP, NT-proBNP and Left Ventricular Ejection Fraction in Patients with Myocardial Infarction

Abstract

Introduction: Soluble Suppression of Tumourigenicity 2 (sST2) represents a clinically relevant biomarker and has predictive evidence in acute Myocardial Infarction (MI) and predicts cardiovascular death and risk of heart failure development in these patients. The data about the correlation of sST2, N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) and high-sensitivity C-reactive protein (hsCRP)in the Indian population is lacking. Aim: To find a correlation of ST2 level at the time of admission with NT-proBNP, hsCRP and Left Ventricular Ejection Fraction (LVEF) in patients with MI, and the association of ST2 levels with mortality. Materials and Methods: This longitudinal observational study was conducted at Poona Hospital and Research Centre, Pune, Maharashtra, India, between June 2018 and August 2019, among 75 myocardial infarction patients above 18 years of age. ST2, NT-proBNP and hsCRP levels were checked within 6 hour of hospitalisation. The primary outcome measures were to study the correlation of ST2 levels at the time of admission with hsCRP, NT-proBNP and LVEF. The secondary outcome measures were to study the association of ST2 levels with in-hospital and one-month mortality. The medians of continuous variables of two groups and three groups were-tested using the Mann-Whitney U test and Kruskal-Wallis H test respectively. The correlation analysis was performed using Spearman’s method. Results: The mean age of the study population was 57.8±7.2 years. The mortality rate was 60% (12/75). ST2 levels showed a statistically significant positive correlation with NT-proBNP (r =0.703, p-value=0.001) and hsCRP (r=0.873, p-value=0.001), whereas, ST2 levels showed a negative correlation with LVEF (r=- 0.711, p-value=0.001) in MI patients. The median ST2 levels were significantly higher in-hospital (215.3 ng/dL vs 94 ng/dL) and one month (219.5 ng/dL vs 92.0 ng/dL) mortality as compared to survived MI patients. Conclusion: ST2 levels showed a statistically significant positive correlation with NT-proBNP and hsCRP and were associated with in-hospital and one month mortality in MI patients.

Keywords

• association
• high-sensitivity c-reactive protein
• left ventricular ejection fraction
• mortality
• n-terminal pro-b-type natriuretic peptide