Prognostic value of plasma ST2 in patients with non-ST segment elevation acute coronary syndrome

Çağrı Kokkoz; Adnan Bilge; Mehmet Irik; Halil I. Dayangaç; Mustafa Hayran; Funda Karbek Akarca; Nimet Bilal Erdem; MusaÇavuş

doi:10.1016/j.tjem.2018.01.003

Çağrı Kokkoz¹, Adnan Bilge², Mehmet Irik³, Halil I. Dayangaç⁴, Mustafa Hayran⁵, Funda Karbek Akarca⁶, Nimet Bilal Erdem⁷, MusaÇavuş²

¹Department of Emergency Medicine, Izmir Cigli State Education Hospital, Izmir, Turkey
²Department of Emergency Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
³Department of Emergency Medicine, Izmir Urla State Hospital, Izmir, Turkey
⁴Department of Emergency Medicine, Yozgat State Hospital, Yozgat, Turkey
⁵Department of Emergency Medicine, Manisa State Hospital, Manisa, Turkey
⁶Department of Emergency Medicine, Faculty of Medicine, Ege University, Izmir Turkey
⁷Department of Emergency Medicine, Bozyaka Education and Research Hospital, Izmir, Turkey

Abstract

Objective: The aim of this study is to detect plasma ST2 levels in patients who were admitted to emergency department with chest pain and diagnosed with non st segment elevation myocardial infarction (NSTEMI) and to research the relationship between 28-day mortality and ST2 levels.

Methods: The present study was conducted at Emergency Department of Celal Bayar University Hafsa Sultan Hospital between September 2015 and January 2016 as a prospective, single-center, cross-sectional study. Plasma ST2 levels were detected in patients who were diagnosed with NSTEMI based on physical examination, ECG and troponin. The eligible patients were followed up with regard to mortality during 28 days.

Results: A total of 88 patients diagnosed with NSTEMI were included in the study and followed up for 28 days. While 18 (20.5%) patients died at the end of 28 days, 70 (79.5%) patients survived. Mean ST2 level of surviving 70 patients was 651.37 ± 985.66 pg/mL and mean ST2 level of dying 18 patients was 2253.66 ± 1721.15 pg/mL (p < 0.001). ST2 value was higher among the dying (non-survivors) compared to the survivors at the end of 28 days and this was found related to mortality. ST2 cut-off value was found as 1000 pg/mL with 72.2% sensitivity and 20.0% specificity.

Conclusion: Among the patients who were diagnosed with NSTEMI at the emergency department, ST2 levels on admission were found significantly higher among the non-survivors compared to the survivors. ST2 level was accepted as a reliable biomarker for prediction of 28 mortality in patients diagnosed with NSTEMI.