ST2 and copeptine – modern biomarkers for monitoring the effectiveness of treatment of decompensated heart failure in patients after acute myocardial infarction

Abstract

The aim of the study was to increase the efficiency of diagnostic methods to find means to improve the treatment of patients with decompensated heart failure in the post-infarction period.
 Materials and methods. This study is based on an examination of 120 patients with decompensated HF (60 patients with STEMI and 60 with non-STEMI). Patients with previous STEMI complicated by decompensated heart failure were divided into groups, depending on their treatment. The studied groups were homogeneous in terms of age, sex, the severity of the course of the disease, duration of the post-infarction period, and the presence of clinical manifestations of decompensation. The patients were observed on the first day after hospitalization, after 1 and 2 months after treatment. Copeptin serum levels were assayed using the EK 065-32, EIA Copeptine kit (RayBiotech, Inc., USA). ST-2 in blood serum was determined with the help of the Presage ST-2 kit (Critical Diagnostics, USA). The level of ST2 was determined in ng/ml.
 Results. We analysed the effect of therapy on the level of ST2 in the blood serum of examined patients with STEMI and non-STEMI complicated by decompensated heart failure. All the treatment regimens we proposed led to a significant decrease in the level of this peptide in blood serum after the end of the treatment. In patients of group I who received basic therapy drugs, the average ST2 concentration was (49.47±1.77) ng/ml before treatment. After 1 and 2 months of therapy, it was (44.92±1.22) ng/ml and (41.67±1.18) ng/ml, respectively (p˂0.05). The patients with decompensated heart failure after non-STEMI from group I had a copeptin level of (18.13±0.10) pg/ml before treatment and probably decreased to levels of (16.29±0.15) pg/ml and (15.09±0.14) pg/ml after 1 and 2 months under the influence standard therapy.
 Conclusions. We found the dependence of copeptin and ST2 levels on decompensated HF in the early and late post-infarction periods. It was established that the use of the therapy with a combination of the studied drugs led to a more intense decrease in serum copeptin, compared to therapy with succinic acid, arginine drugs, and standard therapy (p˂0.05). Using a differentiated treatment algorithm for patients with decompensated heart failure in the post-infarction period, copeptin and ST2 in blood serum increases the effectiveness of treatment and prevents complications.