Soluble ST2 association with outcome of revascularization and the heart failure development in patients with acute myocardial infarction with ST segment elevation

Main Article Content

M. P. Kopytsya
Ya. V. Hilova
I. M. Kutya
Yu. V. Rodionova
L. L Petieniova


The aim – to study the relationship between the sST2 level and the degree of epicardial blood flow recovery and with the heart failure (HF) development in 6 month follow-up in patients with STEMI after PCI.
Materials and methods. The study involved 61 patients with STEMI – 51 (83.6 %) males and 10 (16.4 %) females, with average age of 59.85±10.01 years. Standard clinical and biochemical parameters were determined, as well as sST2 level was measured by enzyme immunoassay using a reagent kit «Presage ST2 analysis, Critical Diagnosis» (USA) in all patients, on the first day of the disease. Patients were divided into two groups depending on the degree of blood flow recovery in a culprit artery (TIMI) The first group (n=12) included patients with TIMI 0, I, II, the second group (n=49) with TIMI III.
Results and discussion. The sST2 level was significantly higher in the first hours of the disease in the group with unrepaired or decreased epicardial blood flow (TIMI 0–II) after PCI (p=0.003). ROC analysis showed that sST2 levels above 34.2 ng/ml, detected in the first hours of the disease, is an independent marker of adverse revascularization (TIMI 0–I) in patients with STEMI with a sensitivity of 92.3 % and a specificity of 62.5 %; the area under curve (the AUC) is 0.8 (95 % CI=0.651–0.873; p=0.001). When conducting a univariate (χ2=17.741; p=0.04) and multivariate (χ2=9.293; p=0.004) logistic analyzes, sST2 was a significant influencer of the unfavorable outcome of epicardial vascular revascularization (TIMI 0–ІІ).
Conclusions. sST2 is highly associated with the degree of epicardial blood flow recovery in patients with STEMI and is of great clinical importance as diagnostic marker.

Article Details


acute myocardial infarction, sST2, TIMI blood flow


Medentseva E.A., Rudyk Yu.S. The role of the ST2 fibrosis marker and angiotensinogen gene polymorphism in the progression of chronic heart failure in patients with type 2 diabetes mellitus (in Russion). Georgian Medical News. 2018;(2):105-12.

Unified clinical protocol for emergency, primary, secondary (specialized), tertiary (highly specialized) medical care and cardiorehabilitation "Acute coronary syndrome with ST-segment elevation": order of the Ministry of Health of Ukraine No. 1936 of September 14, 2021 (in Ukraine). URL:

AbouEzzeddine OF, McKie PM, Dunlay SM, et al. Suppression of tumorigenicity 2 in heart failure with preserved ejection fraction. J Am Heart Assoc. 2017;6(2).pii:e004382. doi:

Aleksova A, Paldino A, Beltrami AP, et al. Cardiac Biomarkers in the Emergency Department: The Role of Soluble ST2 (sST2) in Acute Heart Failure and Acute Coronary Syndrome-There is Meat on the Bone. J Clin Med. 2019;8(2):270. doi:

Bahuleyan CG, Alummoottil GK, Abdullakutty J, et al. Prognostic value of soluble ST2 biomarker in heart failure patients with reduced ejection fraction – A multicenter study. Indian Heart J. 2018;70(1):79-84. doi:

Bayes-Genis A, Zhang Y, Ky B. ST2 and patient prognosis in chronic heart failure. Am J Cardiol. 2015;115(7):64-9. doi:

Borovac JA, Glavas D, Susilovic Grabovac Z, et al. Circulating sST2 and catestatin levels in patients with acute worsening of heart failure: a report from the CATSTAT-HF study. ESC Heart Fail. 2020;7(5):2818-28. doi:

Chou HH, Hsu LA, Juang JJ, et al. Synergistic Effects of Weighted Genetic Risk Scores and Resistin and sST2 Levels on the Prognostication of Long-Term Outcomes in Patients with Coronary Artery Disease. Int J Mol Sci. 2022;23(8):4292. Published 2022 Apr 13. doi:

Huang WP, Zheng X, He L, Su X, Liu CW, Wu MX. Role of Soluble ST2 Levels and Beta-Blockers Dosage on Cardiovascular Events of Patients with Unselected ST-Segment Elevation Myocardial Infarction. Chin Med J (Engl). 2018;131(11):1282-8. doi:

Gu L, Li J. Short-term and long-term prognostic value of circulating soluble suppression of tumorigenicity-2 concentration in acute coronary syndrome: a meta-analysis. Biosci Rep. 2019;39(6):BSR20182441. doi:

Geenen LW, Baggen VJM, van den Bosch AE, et al. Prognostic value of soluble ST2 in adults with congenital heart disease. Heart. 2019;105(13):999-1006. doi:

Ibanez B, James S, Agewall S, et al.; ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-77. doi:

Castiglione V, Aimo A, Vergaro G, Saccaro L, Passino C, Emdin M. Biomarkers for the diagnosis and management of heart failure. Heart Fail Rev. 2022;27(2):625-43. doi:

Crnko S, Printezi MI, Jansen TPJ, et al. Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patients. ESC Heart Fail. 2020;7(3):1224-33. doi:

Lepojärvi ES, Piira OP, Pääkkö E, et al. Serum PINP, PIIINP, galectin-3, and ST2 as surrogates of myocardial fibrosis and echocardiographic left venticular diastolic filling properties. Front Physiol. 2015;6:200. doi:

Li M, Duan L, Cai Y, et al. Prognostic value of soluble suppression of tumorigenesis-2 (sST2) for cardiovascular events in coronary artery disease patients with and without diabetes mellitus. Cardiovasc Diabetol. 2021;20(1):49. doi:

Liu N, Hang T, Gao X, et al. The association between soluble suppression of tumorigenicity-2 and long-term prognosis in patients with coronary artery disease: A meta-analysis. PLoS One. 2020;15(9):e0238775. doi:

Dudek M, Kałużna-Oleksy M, Migaj J, Straburzyńska-Migaj E. Clinical value of soluble ST2 in cardiology. Adv Clin Exp Med. 2020;29(10):1205-10. doi:

Aimo A, Januzzi JL, Antoni Bayes-Genis A, et al. Clinical and Prognostic Significance of sST2 in Heart Failure: JACC Review Topic of the Week. J Am Coll Car. 2019;74(17):2193-203.

Rezar R, Paar V, Seelmaier C, et al. Soluble suppression of tumorigenicity 2 as outcome predictor after cardiopulmonary resuscitation: an observational prospective study. Sci Rep. 2021;11:21756.

van den Berg VJ, Vroegindewey MM, Umans VA, et al. Persistently elevated levels of sST2 after acute coronary syndrome are associated with recurrent cardiac events. Biomarkers. 2022;27(3):264-9. doi:

Shimpo M, Morrow DA, Weinberg EO, et al. Serum levels of the interleukin-1 receptor family member ST2 predict mortality and clinical outcome in acute myocardial infarction. Circulation. 2004;109(18):2186-90. doi:

Somuncu MU, Kalayci B, Avci A, et al. Predicting long-term cardiovascular outcomes of patients with acute myocardial infarction using soluble ST2. Horm Mol Biol Clin Investig. 2020;41(2):10.1515/hmbci-2019-0062. Published 2020 Feb 29. doi:

Stabler ME, Rezaee ME, Parker DM, et al. sST2 as a novel biomarker for the prediction of in-hospital mortality after coronary artery bypass grafting. Biomarkers. 2019;24(3):268-276. doi:

Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction (2018). Eur Heart J. 2019;40(3):237-69. doi:

Tseng CCS, Huibers MMH, Gaykema LH, et al. Soluble ST2 in end-stage heart failure, before and after support with a left ventricular assist device. Eur J Clin Invest. 2018;48(3):e12886. doi:

Villacorta H, Maisel AS. Soluble ST2 Testing: A Promising Biomarker in the Management of Heart Failure. Arq Bras Cardiol. 2016;106(2):145-52. doi:

Lotierzo M, Dupuy AM, Kalmanovich E, Roubille F, Cristol JP. sST2 as a value-added biomarker in heart failure. Clin Chim Acta. 2020;501:120-30. doi:

Vianello E, Dozio E, Tacchini L, Frati L, Corsi Romanelli MM. ST2/IL-33 signaling in cardiac fibrosis. Int J Biochem Cell Biol. 2019;116:105619. doi:

Zhang T, Xu C, Zhao R, et al. Diagnostic Value of sST2 in Cardiovascular Diseases: A Systematic Review and Meta-Analysis. Front Cardiovasc Med. 2021;8:697837. doi: