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biomarker sst2 as an early predictor of acute renal injury in patients with acute myocardial infarction

Session HFA Discoveries - ePosters

Speaker Associate Professor Irina Vishnevskaya

Event : HFA Discoveries 2020

  • Topic : basic science
  • Sub-topic : Basic Science - Cardiac Diseases: Biomarkers
  • Session type : ePosters

Authors : I Vishnevskaya (Kharkiv,UA), MP Kopytsya (Kharkiv,UA), OV Petyunina (Kharkiv,UA), TYE Storozhenko (Kharkiv,UA), NV Titarenko (Kharkiv,UA)

Authors:
I Vishnevskaya1 , MP Kopytsya1 , OV Petyunina1 , TYE Storozhenko1 , NV Titarenko1 , 1L.T. Malaya Therapy national institution of NAMSU - Kharkiv - Ukraine ,

Citation:

One of the serious complications of ST-segment elevation myocardial infarction (STEMI) is acute kidney injury (AKI). Promising in this respect is the stimulating growth factor sST2. A sharp increase of ST2 level in case of injury is accompanied by inhibition of IL-33 favorable antihypertrophic effects.
Purpose. To analyze the prognostic significance of sST2 biomarker in identifying the risk of AKI development in patients with STEMI.
Materials and methods. The study included 103 patients with STEMI, of which 75 patients were men, whose mean age was 61.85 ± 12.23 years. Patients were hospitalized at the intensive care. Patients were subjected selective coronary angiography with subsequent stenting of the infarct-related artery. Criteria for inclusion into the study concerned patients with STEMI, who arrived in the hospital during 24 hours after the onset of the symptoms and agreed to participate in the study. A group of patients selected (n = 68), by which the creatinine level determined over 48 hours. These patients divided into 2 groups depending on the dynamics of serum creatinine level. The first group included 23 patients with an increase in serum creatinine level by more than 26.4 µmol/L for 48 hours, corresponding to the first and higher stages of AKI. The second group included the remaining 45 patients, where the above-indicated dynamics of creatinine were not obtained. The level of sST2 and NT pro BNP was determined during the first 24 hours after the event. The follow-up period was 1 year. The endpoint was determent as all-cause mortality. During the follow-up period, 20 patients reached the endpoint.
Results. It was found that the level of creatinine during hospitalization in patients who died was reliably higher than that in patients who survived (p = 0.05), the same reliability was maintained when comparing creatinine level after 48 hours (p = 0.02). Additionally, in the studied groups, the level of sST2 biomarker (p = 0.008) and NTproBNP (p = 0.0001) differed reliably. As a result of the ROC analysis performed, it was found that creatinine was an independent predictor of an adverse outcome within the 6 months period (AUC 0.664, CI 0.552-0.764, sensitivity 90%, specificity 50%, associated limit> 108 µmol/l). A direct correlation between the level of sST2 and blood serum creatinine was revealed (r = 0.4; p = 0.0006). On this basis, it can be assumed that an increase in the level of a biomarker is associated with the renal function decrease in patients with STEMI. In multivariate regression analysis, we found that sST2 and blood glucose are the only significant predictors of acute kidney injury during the first 48 hours (R2 = 0.437, P <0.001) among the parameters included into the study, such as the NT-pro BNP biomarker, ejection fraction, E/A ratio, end diastolic volume.
Conclusion. The role of the biomarker ST2 in the early stratification of reduced kidney function in patients with STEMI suggests the development of AKI.

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