Soluble ST2 in plasma is associated with post-procedural no-or-slow reflow after primary percutaneous coronary intervention in ST-elevation myocardial infarction
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Soluble ST2 in plasma is associated with post-procedural no-or-slow reflow after primary percutaneous coronary intervention in ST-elevation myocardial infarction. / Søndergaard, Frederik T.; Beske, Rasmus P.; Frydland, Martin; Møller, Jacob Eifer; Helgestad, Ole K.L.; Jensen, Lisette Okkels; Holmvang, Lene; Goetze, Jens P.; Engstrøm, Thomas; Hassager, Christian.
In: European Heart Journal: Acute Cardiovascular Care, Vol. 12, No. 1, 2023, p. 48-52.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Soluble ST2 in plasma is associated with post-procedural no-or-slow reflow after primary percutaneous coronary intervention in ST-elevation myocardial infarction
AU - Søndergaard, Frederik T.
AU - Beske, Rasmus P.
AU - Frydland, Martin
AU - Møller, Jacob Eifer
AU - Helgestad, Ole K.L.
AU - Jensen, Lisette Okkels
AU - Holmvang, Lene
AU - Goetze, Jens P.
AU - Engstrøm, Thomas
AU - Hassager, Christian
N1 - Publisher Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Aim The no-or-slow-reflow phenomenon after primary percutaneous coronary intervention is associated with more extensive myocardial injury in patients with ST-elevation myocardial infarction (STEMI). Soluble suppression of tumourigenicity 2 (sST2) is released in acute myocardial response to injury, and an increase in plasma level in the initial phase of STEMI is associated with increased mortality and risk of heart failure. We have therefore explored the association of pre-intervention plasma sST2 with the post-procedural no-or-slow-reflow phenomenon in patients with STEMI. Methods and results We included consecutive patients with verified STEMI from two tertiary heart centres. Blood samples were collected at admission before angiography. Post-procedural coronary flow was assessed according to thrombolysis in myocardial infarction (TIMI) classification for STEMI. Patients were divided into two groups: post-procedural TIMI 0–2 as no-or-slow reflow and TIMI 3 as normal reflow. The association between sST2 and TIMI flow was explored using multiple logistic regression. A total of 1607 patients with available TIMI flow classification were included in the analysis. Normal reflow was seen in 1520 (94.6%), while 87 (5.4%) had no-or-slow reflow. No-or-slow-reflow patients had higher all-cause 30-day mortality [10 (11%) vs. 65 (4.3%), P = 0.006]. Pre-procedural sST2 was higher in the no-or-slow-flow group [47 ng/mL, interquartile range (IQR, 33–83) vs. 39 ng/mL (IQR 29–55), P < 0.001] and was independently associated with post-procedural no-or-slow flow [twofold sST2 increase: odds ratio 1.44 (1.15–1.78), P = 0.0012]. Conclusion In patients with STEMI, the sST2 level at admission before coronary angiography is independently associated with the post-procedural no-or-slow-reflow phenomenon.
AB - Aim The no-or-slow-reflow phenomenon after primary percutaneous coronary intervention is associated with more extensive myocardial injury in patients with ST-elevation myocardial infarction (STEMI). Soluble suppression of tumourigenicity 2 (sST2) is released in acute myocardial response to injury, and an increase in plasma level in the initial phase of STEMI is associated with increased mortality and risk of heart failure. We have therefore explored the association of pre-intervention plasma sST2 with the post-procedural no-or-slow-reflow phenomenon in patients with STEMI. Methods and results We included consecutive patients with verified STEMI from two tertiary heart centres. Blood samples were collected at admission before angiography. Post-procedural coronary flow was assessed according to thrombolysis in myocardial infarction (TIMI) classification for STEMI. Patients were divided into two groups: post-procedural TIMI 0–2 as no-or-slow reflow and TIMI 3 as normal reflow. The association between sST2 and TIMI flow was explored using multiple logistic regression. A total of 1607 patients with available TIMI flow classification were included in the analysis. Normal reflow was seen in 1520 (94.6%), while 87 (5.4%) had no-or-slow reflow. No-or-slow-reflow patients had higher all-cause 30-day mortality [10 (11%) vs. 65 (4.3%), P = 0.006]. Pre-procedural sST2 was higher in the no-or-slow-flow group [47 ng/mL, interquartile range (IQR, 33–83) vs. 39 ng/mL (IQR 29–55), P < 0.001] and was independently associated with post-procedural no-or-slow flow [twofold sST2 increase: odds ratio 1.44 (1.15–1.78), P = 0.0012]. Conclusion In patients with STEMI, the sST2 level at admission before coronary angiography is independently associated with the post-procedural no-or-slow-reflow phenomenon.
KW - No-reflow phenomenon
KW - Soluble ST2
KW - ST-elevation myocardial infarction
U2 - 10.1093/ehjacc/zuac146
DO - 10.1093/ehjacc/zuac146
M3 - Journal article
C2 - 36355574
AN - SCOPUS:85162243142
VL - 12
SP - 48
EP - 52
JO - European Heart Journal: Acute Cardiovascular Care
JF - European Heart Journal: Acute Cardiovascular Care
SN - 2048-8726
IS - 1
ER -
ID: 366828272