Introduction Soluble ST2 (sST2) is increased during acute myocardial infarction. The point of care test (POCT) for sST2 is currently available. The aim of this study was to investigate the utility of the sST2 POCT measurement for predicting adverse cardiac events during acute care of ST-elevation myocardial infarction (STEMI). Patients and Methods This research used a cohort study design. Consecutive patients with STEMI were enrolled. Soluble ST2 level was measured from peripheral blood taken on admission with POCT. Observation during acute intensive care was conducted to record adverse cardiac events. Two groups were assigned based on median sST2 level, that is, supramedian and inframedian group. The incidence of adverse cardiac events between groups was analyzed. A p value < 0.05 was statistically significant. Results We analyzed 95 subjects with STEMI and 10 patients with stable coronary artery disease as controls. The median sST2 level was significantly higher in subjects with STEMI as compared to controls (152.1 ng/mL versus 28.5 ng/mL, p < 0.01). Among subjects with STEMI, the supramedian group had higher incidence of adverse cardiac events than the inframedian group (38.3% versus 12.5%, p=0.004). Multivariable analysis showed that supramedian sST2 level was independently associated with increased incidence of adverse cardiac events (adjusted OR 6.27; 95% CI: 1.33–29.47, p=0.020). Conclusions The sST2 POCT measurement was useful to independently predict adverse cardiac events during acute intensive care of STEMI.

Introduction. Serum endothelin-1 is increasingly released in acute myocardial infarction, by necrotic cardiomyocytes. In non-ST-elevation acute myocardial infarction (Non-STEMI), increased serum endothelin-1 on-admission may have clinical significance during acute hospitalisation events. Objective. The purpose of this study is to investigate whether increased serum endothelin-1 level predict adverse cardiac events in patients hospitalized with Non-STEMI. Methods. The design of this research was a prospective cohort study. Consecutive subjects with Non-STEMI undergoing symptom onset ≤24 hour were enrolled and observed during intensive hospitalization. Serum endothelin-1, troponin-I, and hs-C reactive protein were measured from peripheral blood taken on-admission. In-hospital adverse cardiac events were a composite of death, acute heart failure, cardiogenic shock, reinfarction, and resuscitated VT/VF. Results. We enrolled 66 subjects. The incidence of in-hospital adverse cardiac events is 13.6% (10 out of 66 subjects). Serum endothelin-1 level was significantly higher in subjects with in-hospital adverse cardiac events. Subjects with endothelin-1 level >2.59 pg/mL independently predicted adverse cardiac events in hospitalised Non-STEMI patients (adjusted odds ratio 44.43, 95% confidence interval: 1.44-1372.99, p value 0.03). The serum endothelin-1 level was correlated with serum troponin I level (correlation coefficient of 0.413, p value 0.012). Conclusion. Increased serum endothelin-1 on-admission correlated with increased troponin-I and independently predicted in-hospital adverse cardiac events in patients with Non-STEMI.

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Background: Soluble ST2 (sST2) is released by strained myocardial. High baseline sST2 levels have been shown to be a predictor of mortality and heart failure in STEMI patients within 30 days and within 1 year, but its effect on medium-term events has not been widely investigated. Aims: To assess the prognostic factor of sST2 levels during admission with major cardiovascular events in the form of cardiovascular death and heart failure due to left ventricular dysfunction within 90 days of observation. Methods: A retrospective cohort study was conducted on STEMI patients with an onset of ≤ 24 hours undergoing reperfusion therapy from April 2014 - June 2015 in Dr. Sardjito General Hospital, Yogyakarta, Indonesia. The sST2 sample of venous blood was performed at admission. Primary outcomes for this analysis included cardiovascular death and congestive heart failure (CHF) through 90 days of follow-up. Assessment of major cardiovascular events was based on medical record data. Bivariate analysis were conducted on demographic and clinical factors related to sST2 and major cardiovascular events. A multivariate analysis was then conducted to determine the independent factors that influenced the emergence of major cardiovascular events. Results: Of the 107 patients who met the subject criteria, there were 33 (30.8%) subjects withmajor cardiovascular events and 74 subjects (69.2%) without major cardiovascular events in 90 days of observation. Of the 33 subjects with major cardiovascular events, there were 10 subjects (9.3%) died and 23 subjects (21.5%) with heart failure. The sST2 levels did not have a significant relationship with the incidence of mortality (p=0.617), heart failure (p=1.000), orboth combined (p = 1.000) in 90 days of observation. Conclusion: High serum sST2 levels during admission in STEMI patients who had undergonereperfusion therapy were not associated with increased incidence of major cardiovascular events (either the incidence of mortality or heart failure alone or both combined) in 90 days observation.

Background: Inflammatory biomarkers are associated with adverse cardiovascular events during ST-elevation acute myocardial infarction (STEMI). We aimed to investigate the role of inflammatory biomarkers, high-sensitivity C-reactive protein (hs-CRP), and soluble ST-2 (sST2), for prediction of adverse cardiovascular events in STEMI. Methods: This was a prospective cohort study that consecutively enrolled patients with STEMI. Subjects were observed during hospitalization until discharge or fatal events happened. Adverse cardiovascular event was a compilation of cardiac mortality, acute heart failure, cardiogenic shock, reinfarction, and malignant ventricular arrhythmia. Blood samples were withdrawn on admission and inflammatory biomarkers (hs-CRP and sST2) were measured. The receiver operator characteristics curve and multivariable analysis were performed to determine which inflammatory biomarkers predict in-hospital adverse cardiovascular events and mortality. Result: Of 166 subjects, the in-hospital adverse cardiovascular events occurred in 41 subjects (24.6%) and mortality occurred in 16 subjects (9.6%). Subjects with in-hospital adverse cardiovascular events and mortality had a significantly higher hs-CRP level, but comparable sST2 level than subjects without events. The hs-CRP level was the most precise biomarkers to predict in-hospital adverse cardiovascular events (hs-CRP cut-off ≥2.75 mg/L) and mortality (hs-CRP cut-off ≥7 mg/L). Multivariable analysis indicated hs-CRP ≥2.75 mg/L as an independent predictor for in-hospital adverse cardiovascular events (adjusted odds ratio [OR]: 2.79, 95% confidence interval [CI]: 1.05-7.39, P = .039) and hs-CRP ≥7 mg/L for mortality (adjusted OR: 5.45, 95% CI: 1.13-26.18, P = .034) in STEMI. Conclusion: On admission, hs-CRP level independently predicted in-hospital adverse cardiovascular events, at cut-off level ≥2.75 mg/L, and mortality, at cut-off level ≥7 mg/L, in STEMI patients.