| Objective:In order to identify the value of prognosis, we assayed level of serum soluble ST2(sST2) in AMI patients and analyzed the correlation with NT-proBNP, which can provide a theoretical basis for early intervention of AMI patients.Methods:A total of 56 AMI patients admitted to Cardiology Department of the First Hospital of Shan Xi Medical University from Nov. 2014 to Mar. 2015, and 20 controls were selected. The AMI diagnostic criterion complied with the standard of American College of Cardiology and the American College of Cardiology(ACC / AHA) guidelines. The control patients was who had not explicit history of heart disease and coronary heart disease related symptoms as the main symptoms of admission. General information collection: collect the results of clinical data, laboratory parameters and ultrasonic cardiogram, and record the cardiovascular events of AMI patients during hospitalization including post-infarction angina, heart failure and death. Coronary angiography: all AMI patients underwent coronary angiography via radial artery pathway by the Coronary angiography room of our hospital, who met coronary angiography indications and had no contraindications in 7-10 days after myocardial infarction. The degree of stenosis represented with diameter reduction percentage. We assessed severity of coronary artery through improved Gensini scoring system and analyzed the relationship between the degree of coronary artery disease and sST2 level. The AMI patients who admitted to hospital the next day, the third day and the non-AMI patients who admitted to hospitalthe next day draw fasting vein blood for testing sST2. The sST2 levels was assayed by enzyme-linked immunosorbent assay(enzyme linked immunosorbent assay, ELISA)assay. The reagents were purchased from R&D company and analyed by Thermo Scientific microplate colorimetric. Statistical analysis: Using SPSS17.0 statistical software for statistical analysis. Continuous variables were measured in normality test,normally distributed measurement data was shown as mean ± standard deviation,skewness of the distribution measurement data shown as Md(IQR). T test, analysis of variance or non-parametric tests was used, when measurement data was compared among all groups. When comparing constituent ratios between groups, chi-square test analysis was used. Correlation analysis used Spearman method. P <0.05 was considered significant differences.Results:1.The comparion of baseline sST2 level between AMI group and the control group:serum sST2 baseline level of AMI was 10.30(7.21~20.14)ng/ml, sST2 level of control group was 8.35(6.02~9.66)ng/ml, the difference between the two groups was statistically significant(P <0.05). 2.The change of sST2 level with AMI: the sST2 level of AMI on the third day after admission was(5.45~14.72)ng/ml, which was lower than first day10.30(7.21~20.14) ng/ml, the difference was statistically significant(P <0.05). 3.The patients was divided into <13 group, 13 to 26 group, 26 to 52 group and >52 group according to Gensini score, the difference of sST2 level among four groups was statistically significant(P <0.05) and the sST2 level of Gensini score >52 group was highest. 4.The relationship between sST2 level of AMI patients and heart function: the sST2 levels of killip I-II patients were significantly lower than killip III-IV(P<0.05); the sST2 levels in patients with LVEF<50% were higher than LVEF≥50%(P<0.05). 5.The short-term prognosis of sST2 in AMI patients: area under ROC curves of sST2 and NT-proBNP were 0.814 and 0.711, the AUC of sST2 was higher than NT-proBNP, the difference was statistically significant(P <0.05); there were differences with differentprognosis in AMI(P <0.05), the sST2 level of sudden cardiac death patients was higher than other groups.Conclusion:1.The level of sST2 were significantly increased at the early time of AMI and trended lower from the first day(average 20.2h after AMI) to the third day(average 68.2h after AMI) after AMI. 2.With aggravation of stenosis in coronary artery, the sST2 levels was elevated(except Gensini score <13 group). 3.The poorer cardiac function with AMI patients, the higher level of sST2. 4.The short-term prognotic value in patients with AMI was higher than NT-proBNP, the short-term prognosis of higher sST2 patients was poorer. |
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