Lack of Superiority for Soluble ST2 over High Sensitive C-Reactive Protein in Predicting High Risk Coronary Artery Calcium Score in a Community Cohort

Abstract

PurposeSoluble ST2 (sST2) is an emerging prognostic biomarker in patients with cardiovascular disease (CVD). A recent study showed that sST2 predicted incident hypertension. High sensitive C-reactive protein (hsCRP) has been a widely-used biomarker for risk-stratifying in CVD. We compared the abilities of sST2 and hsCRP to predict high risk coronary artery calcium score (CACS).Materials and MethodsThe CACS was assessed by cardiac computed tomography, and sST2 was measured in 456 subjects enrolled in the Mapo-gu community cohort. In accordance with the 2013 ACC/AHA guidelines, we defined the high risk CACS group as individuals with a CACS ≥300 Agatston units (AU).ResultsThere were 99 (21.7%) subjects with a CACS ≥300 AU. There was a strong correlation between log sST2 and log hsCRP (r=0.128, p=0.006), and both log sST2 and log hsCRP showed significant associations with CACS (r=0.101, p=0.031 for sST2, r=0.101, p=0.032 for hsCRP). In net reclassification improvement (NRI) analysis, the NRI for hsCRP over sST2 was significant [continuous NRI 0.238, 95% confidence interval (CI) 0.001–0.474, integrated discrimination index (IDI) 0.022, p=0.035], while the NRI for sST2 over hsCRP was not significant (continuous NRI 0.212, 95% CI -0.255–0.453, IDI 0.002, p=0.269).ConclusionsST2 does not improve net reclassification for predicting a high risk CACS. Using hsCRP provides superior discrimination and risk reclassification for coronary atherosclerosis, compared with sST2.

Soluble ST2 and its relation to inflammatory, vascular atherosclerotic, and calcification markers in patients with atrial fibrillation or heart failure at moderate-to-high cardiovascular risk

“…The same negative association between TC/HDL-C and sST2 was also found in our control group. This is in agreement with the results from the cohort community-based study, where they found significant negative correlation between TC and LDL-C with sST2 [31]. On the contrary, the hsCRP was positively related with the TC and LDL-C in this general population of Asian origin.…”

“…The only biomarker which predicted the IMT and plaque change in internal carotid artery wall, but not of common carotid artery, was plasma growth differentiation factor-15, while sST2 and high-sensitive Troponin I failed to do that. Study on a Korean cohort did not found difference between the sST2 levels and the CACS category (high vs. low risk) [31]. However, they found a mild positive correlation with r=0.10 between sST2 and CACS, which are in agreement with our results (p=0.031) and (r=0.288, p=0.036 for CACS=0; r=0.237, p=0.039 for CACS>0).…”

“…However, the results from the Framingham Heart Study showed higher values for males than in females [30]. The same sex difference in the sST2 values was also reported in a Korean population sample [31], in patients with HF and CVD and in the general population [32]. We did not found associations of sST2 with age, arterial hypertension, and obesity for both AF and HFpEF patients.…”

Estimation of HsCRP and Cardiac Troponin I in Ischemic Heart Disease Iraqi Patients

“…Regarding to the correlation between HsCRP level and the IHD risk factors, no significant correlation was found between HsCRP marker and each of the triglyceride level (26) and the blood pressure (27) in both SA and UA patients. While in MI patients, there was a perfect positive correlation between the triglyceride level and the HsCRP level (28) . The results of (Hage, 2014) study (29) observed that the HsCRP was significantly associated with systolic blood pressure in IHD.…”

Clinical study of chlamydia pneumoniae infection in patients with coronary heart disease

“…Furthermore, the level of IMT is significantly higher in CHD patients with CP infection than in CHD patients without CP infection, and unstable plaques mostly manifest as common in carotid plaques. The results of the study conducted by Oh J et al revealed that [14, 15] CP infection was also correlated to the severity of CHD, and that the positive rate of serum CP-IgG was significantly higher in patients with acute myocardial infarction and unstable angina pectoris, when compared to patients with stable angina pectoris or healthy people. In the study conducted by Yuguang Sun et al [16–19], the researchers analyzed the correlation between CP infection and levels of inflammatory factors and blood lipids in patients with CHD.…”