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Role of novel biomarkers of renal injury in patients with st segment elevation myocardial infarction

Session Poster Session 3

Speaker Associate Professor Irina Vishnevskaya

Event : Heart Failure 2019

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease – Pathophysiology and Mechanisms
  • Session type : Poster Session

Authors : IR Vyshnevska (Kharkiv,UA), MP Kopytsya (Kharkiv,UA), YV Hilova (Kharkiv,UA), OV Petyunina (Kharkiv,UA)

IR Vyshnevska1 , MP Kopytsya1 , YV Hilova1 , OV Petyunina1 , 1Government institution“L.T. Malaya Therapy National institute of the National academy of medical sci - Kharkiv - Ukraine ,


Acute deterioration of renal function in patients with ST-segment elevation myocardial infarction (STEMI) is a crucial issue nowadays because it worsens the prognosis. The search for new biomarkers is going on to prevent the acute worsening of kidney functions. One of the promising of biomarker is the soluble ST2 (sST2).

Purpose: to determine the role of soluble ST2 in the prognosis of acute deterioration of renal function in ST-segment elevation myocardial infarction patients.

Methods: 103 STEMI patients with a mean age of 61.85 ± 12.23 years were enrolled to this study (72.8% male and 27.2% female). All patients had to undergo baseline investigations, including the: standard electrocardiography, echocardiography, angiography, determination of marker of myocardial necrosis – cardiac troponin I and level of serum creatinine; the glomerular filtration rate (GFR) was estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Accordingly, to the result, a group of patients has been selected (n= 59), their creatinine level was determined during the first 24 hours and after 48 hours of admission. The clinical evaluation, N-terminal pro-brain natriuretic peptide (NT-pro BNP) and sST2 serum levels were estimated once during the first day after STEMI.

Results. Receiver operating characteristic curve (ROC) for baseline showed that the optimal cut-off value of sST2 to predict deterioration of renal function was 36 ng/ml, with a sensitivity (Se) and specificity (Spe) of 77% and 60%, respectively (Area under curve (AUC) 0.67; 95% confidence interval (CI) 0.53-0.8; p=0.02). ROC curve for NT-pro BNP showed the cut-off value was equal to 1345 ng/ml (AUC=0.75; 95% CI 0.56-0.94; Se 60%; Spe 95%; p=0.0089). In a multiple regression model, we found sST2 and blood glucose to be the only significant predictors of acute kidney injury during the first 48 hours of investigation (adj. R2 =0.437, P<0.001) among the parameters included in the study such as the biomarker NT-pro BNP, ejection fraction, E/A ratio, end-diastolic volume and hemoglobin level. Conclusion. The study revealed that sST2 predicts acute kidney injury in patients with ST-segment elevation myocardial infarction and could be useful especially in patients who underwent angiography.

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