Clinical and diagnostic significance of stimulating growth factor (ST2) for evaluation of early complications in myocardial infarction

Aim: The aim of the study was to determine the ST2 and NT-proBNP contents in blood serum of patients with myocardial infarction (MI) during in-hospital follow up depending on the presence of hospital complications and to elucidate their relationships with the types of myocardial remodeling. Materials and Methods: A total of 88 MI patients aged 59±8.36 years were studied. At days 1 and 12, the ST2 and NT-proBNP contents were assessed in blood serum by the immunoenzyme method. Control group comprised 30 patients. Statistical analysis of data was performed by non-parametric criteria. Results: ST2 level was by 2 times higher in patients with unfavorable outcome at day 1 of in-hospital period than in patients with favorable MI course and by 3.7 times higher than in control. A decrease in the level of the marker was observed at day 12 in both groups. At day 1 of MI, the level of NT-proBNP was by 6.8 times higher in patients with unfavorable prognosis than in control and by 1.8 times higher than in group of favorable course. At day 12, the levels of NT-proBNP remained increased in both groups. Determination of ST2 in a combination with NT-proBNP enhanced their diagnostic value (OR 1.92; 95%CI (1.7-3.2) AUG=0.89; р=0.004). High level of ST2 at day 1 of MI was associated with disadaptive variant of remodeling and exceeded by 1.5 times the corresponding value in group of adaptive remodeling (OR=4.5, 95%CI=2.0-10.1; р=0.011; AUG=0.81) unlike the NT-proBNP content that was similar in both groups during the entire in-hospital period. Conclusions: (1) The course of in-hospital MI period was characterized by the high contents of ST2 and NT-proBNP in blood serum. (2) Complications of in-hospital MI period were associated with higher levels of ST2 compared with NT-proBNP. However, the combined use of the ST2 and NT-proBNP values demonstrated higher diagnostic sensitivity and specificity. (3) Increased content of ST2 in blood serum was accompanied by the development of disadaptive variant of heart remodeling.