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New biomarker for prediction of adverse outcomes in patients with acute myocardial infarction

Session Poster Session 1

Speaker Associate Professor Irina Vishnevskaya

Event : Acute Cardiovascular Care 2016

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : ST-Elevation Myocardial Infarction (STEMI)
  • Session type : Poster Session

Authors : Y Giliova (Kharkiv,UA), MP Kopytsya (Kharkiv,UA), IR Vyshnevska (Kharkiv,UA), OV Petyunina (Kharkiv,UA), NV Tytarenko (Kharkiv,UA), JV Rodionova (Kharkiv,UA), IN Kutya (Kharkiv,UA), LN Petyunina (Kharkiv,UA)

Authors:
Y Giliova1 , MP Kopytsya1 , IR Vyshnevska1 , OV Petyunina1 , NV Tytarenko1 , JV Rodionova1 , IN Kutya1 , LN Petyunina1 , 1National Institute of Therapy n.a. L.T.Malaya of NAMS of Ukraine, Cardiology Department - Kharkiv - Ukraine ,

Citation:
European Heart Journal Supplement ( 2010 ) 12 ( Supplement F ), F32

During the first month after a myocardial infarction (MI), death can occur due to cardiogenic shock, sudden cardiac death, heart failure and other events. The search for new markers that significantly predict adverse outcomes after acute myocardial infarction (AMI) is still going. ST2 is a member of the interleukin-1 receptor family biomarkers. It is being actively studied in the field of myocardial infarction prognosis.
Purpose: to determine significance of ST2 in prognosis of 30-day mortality after AMI.
Methods: 83 patients with ST-elevation myocardial infarction (STEMI) were included in the study, they were admitted to the hospital from 2014 to 2016, signed the informed consent: 70% men and 30% women, mean age was 61,70±1,35 years. All patients underwent a baseline investigation which includes: standard electrocardiography, echocardiography, angiography, determination of marker of myocardial necrosis – cardiac troponin T. GRACE score has been used for risk stratification. The glomerular filtration rate (GFR) was estimated by Cockcroft-Gault formula. In addition, the level of ST2, N terminal-pro B-type natriuretic peptide (NT-pro BNP) were determined during the first day of hospitalization. The endpoints were all-cause mortality. During 30-day follow-up 15,7% patients died.
Results: different variables of clinical, instrumental and laboratory status were put to comparison on surviving and non-surviving patients. GRACE score (p≤0.0004), the level of serum creatinine (p≤0.002), GFR (p≤0.01), the level of biomarkers NT - pro BNP (p≤0.0006) and ST2 (p≤0.00001) were significantly different in those groups. Average value of ST2 for all patients was 63,73±7,96 ng/ml, in surviving patients - 47,5±5,8 ng/ml, in non-survivng - 150,9±31,0 ng/ml. For identification of the main risk factor for adverse outcome, we have used logistic regression method and found ST2 (area under the ROC curve 0.88; p<0.0001; 95% confidence interval: 0.790 – 0.941) with 98 % of sensitivity and 63 % of specificity can predict 30-day mortality in patients after AMI.
Conclusions: biomarker ST2 was the best for predicting 30-day mortality after admission and could be used in combination with other markers in clinical practice to improve risk stratification of patients with AMI.

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