The Prognostic Value Of Serum Soluble ST2 In Patients With ST-segment Elevation Myocardial Infarction

ObjectiveTo investigate roles of serum ST2 in predicting the prognosis of ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI),through correlational analyses of ST2 and the stenosis of coronary artery.MethodGroups:All the patient selected admitted in Department of Cardiology in Yanbian University Hospital from Aug.2016 to Dec.2016Control group:Twenty-six patients in control group had no history of heart disease,and coronary arteriography test result of them were negative,without stenosis and occlusion in their main coronary arteries.Experimental group:Thirty AMI patients are in experimental group met the inclusion criteria(2018 Chinese Guidelines for the diagnosis and management of STEMI).All the patients both in experimental group and control group underwent echocardiographic and laboratory examinations,the AMI patients in experimental group got coronaiy arteriographic examination and required emergency percutaneous coronary intervention(PCI)followed 2015 Chinese Guidelines of AMI in addition,and the stenosis and obstruction of their coronary had graded in SYNTAX score system.Blood samples were collected from all the included patients,centrifugat 2ml venous blood in 3000 rpm 5min and get the supeematant in Cryogenic Vials and put them in the refrigeratornunning at-80?.After 48-72h of AMI patients in experimental group have done PCI,drew venous blood of whom on an empty stomach,and then centrifugat 2ml venous blood in 3000 rpm 5min and obtain the supernatant in Cryogenic Vials and put them in the refrigerator running at-80?.Soluble ST2 levels were measured with enzyme-linked immunosorbent assay(ELISA),according to the manufacturer's instructions.Results1.A signifcant increase in sST2 serum levels was observed after the STEMI done PCI,the sST2 levels before and after PCI both were significantly higher compared with the sST2 levels of patients in control group(P<0.05).2.All the patients were grouped by LVEF%in two groups,LVEF<50%group and LVEF?50%group.There was no difference between sST2 serum levels before PCI in LVEF<50%group and LVEF>50%group(P>0.05);After PCI the sST2 serum levels of patients in LVEF<50%group were significantly higher than patients in LVEF?50%group(P<0.05),.3.Divide the patient into three groups according their SYNTAX scxore.Patients who has low complexity coronary disease with SYNTAX scores ?23 in low SYNTAX scores(0-22)group,and the other two groups were the patients with intermediate SYNTAX scores(22-32)and high SYNTAX scores(>33).Before PCI,there was no difference between ST2 serum levels in low SYNTAX scores group and intermediate SYNTAX scores group,and the ST2 serum levels of patients with high SYNTAX scores group were significantly higher than low SYNTAX scores group and intermediate SYNTAX scores group.After PCI,ST2 serum levels in intermediate SYNTAX scores group was significantly higher than low SYNTAX scores group,and the ST2 serum levels in high SYNTAX scores group were significantly higher than low SYNTAX scores group and intermediate SYNTAX scores group.From pre to post PCI,ST2 serum levels was correlation with SYNTAX scores.In low SYNTAX scores group,ST2 serum levels was significantly declined after PCI,but ST2 serum levels both of intermediate and high SYNTAX scores groups did not declined significantly.(P,?=0.204,P ?=0.63).4.According to how the prognosis was,devided the patient into two group,one group is the patient had got Heart Failure(HF),another group is the asymptomatic patient.Before the PCI,there was no differences between ST2 serum levels in HF group and Asymptomatic group(P<0.05).After the PCI,ST2 serum levels in HF group was significantly higher than Asymptomatic group.From pre to post PCI,ST2 serum levels in Asymptomatic group was significantly declined after PCI(P<0.05);But the ST2 serum levels in HF group was significantly increased after PCI(P<0.05).Conclusion1.Serum ST2 levels evaluate the severity of coronary stenosis of STEMI patients.2.Serum ST2 levels evaluate therapeutic effect in order that adjust dosage regiunen in time.3.After PCI,the serum of STEMI patients predict the incidence of HF in order that take precution against HF.