Prognostic Value Of SST2 In Patients With Non-ST Segment Elevation Acute Coronary Syndrome Complicated With Diabetes

Objective: It is known that the level of sST2 has prognostic value in patients with acute myocardial infarction and heart failure,but there are few studies on NSTE-ACS and patients with diabetes.The purpose of this study is to determine the predictive value of sST2 in patients with NSTE-ACS and diabetes.Methods: From November 2018 to February 2019,213 patients with NSTE-ACS who underwent PCI were followed up for 9 months.The end points of the study were major adverse cardiovascular events((MACE),including recurrent angina pectoris,recurrent myocardial infarction,stroke,unplanned coronary revascularization,new-onset heart failure and cardiovascular death.The correlation between sST2 and other indexes was analyzed by Spearman,the cut-off value and predictive efficiency of the sST2 were analyzed by ROC curve,the difference of survival rate between the two groups was compared by Kaplan-Meier,and the predictive ability of sST2 to MACE in patients with NSTE-ACS was analyzed by Cox regression.Results:During the 9-month follow-up,12 patients lost follow-up,and a total of 201 patients entered the final analysis,of which 23 patients had an incidence of MACE,events(11.4%).The serum sST2 level in MACE(+)group was significantly higher than that in MACE(-)group [(42.68 ±22.35)ng/mL vs(24.77 ±12.91)ng/mL],and the difference was statistically significant(p<0.001).ROC curve analysis shows that the cut-off value of sST2 to predict the occurrence of MACE is 34.5 ng / ml,the sensitivity is60.9%,and the specificity is 82.6%.According to the cut-off value of sST2,the patients were divided into high group and low group.The patients with high sST2 were older,the peak value of cardiac troponin,brain natriuretic peptide and creatinine were higher,and the coronary artery disease was more severe.Cox multivariate regression analysis showed that adjusted for NT-proBNP,LVEF,glycosylated hemoglobin and the number of diseased coronary arteries,sST2 ? 34.5 ng/mL(OR=3.66,95%CI=1.44-9.29,P=0.006)was an independent predictor of 9-month MACE in patients with NSTE-ACS.According to the Kaplan-Meier survival curve,the incidence of MACE was also higherin NSTE-ACS patients with high sST2 level,and the prognosis was worse in patients with high sST2 level complicated with diabetes mellitus(p<0.001).Conclusion: High sST2 levels are associated with NSTE-ACS and 9-month MACE in patients with diabetes.For patients with sST2?34.5ng / m L and diabetes,more active treatment and follow-up should be used.