摘要
Background： Serum soluble ST2 （sST2） levels are elevated early after acute myocardial infarction and are related to adverse left ventricular （LV） remodeling and cardiovascular outcomes in ST-segment elevation myocardial infarction （STEMI）. Beta-blockers （BB） have been shown to improve LV remodeling and survival. However, the relationship between sST2, final therapeutic BB dose, and cardiovascular outcomes in STEMI patients remains unknown. Methods： A total of 186 STEMI patients were enrolled at the Wuhan Asia Heart Hospital between January 2015 and June 2015. All patients received standard treatment and were followed up for 1 year. Serum sST2 was measured at baseline. Patients were divided into four groups according to their baseline sST2 values （high 〉56 ng/ml vs. low ≤56 ng/ml） and final therapeutic BB dose （high ≥47.5 mg/d vs. low 〈47.5 mg/d）. Cox regression analyses were performed to determine whether sST2 and BB were independent risk factors for cardiovascular events in STEMI. Results： Baseline sST2 levels were positively correlated with heart rate （r = 0.327, P = 0.002）, Killip class （r = 0.408, P = 0.000）, lg N-terminal prohormone B-type natriuretic peptide （r = 0.467, P = 0.000）, lg troponin I （r = 0.331, P = 0.000）, and lg C-reactive protein （r = 0.307, P = 0.000） and negatively correlated to systolic blood pressure （r = ？0.243, P = 0.009） and LV ejection fraction （r = ？0.402, P = 0.000）. Patients with higher baseline sST2 concentrations who were not titrated to high-dose BB therapy （P 〈 0.0001） had worse outcomes. Baseline high sST2 （hazard ratio [HR]： 2.653; 95% confidence interval [CI]： 1.201–8.929; P = 0.041） and final low BB dosage （HR： 1.904; 95% CI, 1.084–3.053; P = 0.035） were independent predictors of cardiovascular events in STEMI. Conclusions： High baseline sST2 levels and final low BB dosage predicted cardiovascular events in STEMI. Hence, sST2 may be a useful biomarker in cardiac pathophysiology.
Background： Serum soluble ST2 （sST2） levels are elevated early after acute myocardial infarction and are related to adverse left ventricular （LV） remodeling and cardiovascular outcomes in ST-segment elevation myocardial infarction （STEMI）. Beta-blockers （BB） have been shown to improve LV remodeling and survival. However, the relationship between sST2, final therapeutic BB dose, and cardiovascular outcomes in STEMI patients remains unknown. Methods： A total of 186 STEMI patients were enrolled at the Wuhan Asia Heart Hospital between January 2015 and June 2015. All patients received standard treatment and were followed up for 1 year. Serum sST2 was measured at baseline. Patients were divided into four groups according to their baseline sST2 values （high 〉56 ng/ml vs. low ≤56 ng/ml） and final therapeutic BB dose （high ≥47.5 mg/d vs. low 〈47.5 mg/d）. Cox regression analyses were performed to determine whether sST2 and BB were independent risk factors for cardiovascular events in STEMI. Results： Baseline sST2 levels were positively correlated with heart rate （r = 0.327, P = 0.002）, Killip class （r = 0.408, P = 0.000）, lg N-terminal prohormone B-type natriuretic peptide （r = 0.467, P = 0.000）, lg troponin I （r = 0.331, P = 0.000）, and lg C-reactive protein （r = 0.307, P = 0.000） and negatively correlated to systolic blood pressure （r = ？0.243, P = 0.009） and LV ejection fraction （r = ？0.402, P = 0.000）. Patients with higher baseline sST2 concentrations who were not titrated to high-dose BB therapy （P 〈 0.0001） had worse outcomes. Baseline high sST2 （hazard ratio [HR]： 2.653; 95% confidence interval [CI]： 1.201–8.929; P = 0.041） and final low BB dosage （HR： 1.904; 95% CI, 1.084–3.053; P = 0.035） were independent predictors of cardiovascular events in STEMI. Conclusions： High baseline sST2 levels and final low BB dosage predicted cardiovascular events in STEMI. Hence, sST2 may be a useful biomarker in cardiac pathophysiology.
