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Prognosis value of serum soluble ST2 level in acute ischemic stroke and STEMI patients in the era of mechanical reperfusion therapy

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Abstract

Background

Soluble form suppression of tumorigenicity 2 (sST2) is known to have prognostic value in ST-elevation myocardial infarction (STEMI) and could impact mortality after acute ischemic stroke (AIS). However, before considering sST2 as a therapeutic target, the kinetics of release and its association with adverse clinical events in both STEMI and AIS patients have to be determined.

Methods

We prospectively enrolled 251 STEMI patients, treated with primary percutaneous coronary intervention, and 152 AIS patients treated with mechanical thrombectomy. We evaluated the level of sST2 in patient sera at five time point (admission, 4, 24, 48 h and 1 month from admission for STEMI patients and admission, 6, 24, 48 h and 3 months from admission for AIS patients). Major adverse clinical events (MACE) (all-cause death, acute myocardial infarction, stroke or hospitalization for heart failure) in STEMI patients and all-cause death in AIS patients were recorded during a 12-month follow-up.

Results

Mean age of the study population was 59 ± 12 and 69 ± 15 years in STEMI and AIS patients, respectively. In STEMI patients, sST2 peaked 24 h after admission (25.5 ng/mL interquartile range (IQR) [14.9–29.1]) whereas an earlier and lower peak was observed in AIS patients (16.8 ng/mL IQR [15.2–18.3] at 6 h). Twenty-five (10.0%) STEMI patients experienced a MACE and 12 (7.9%) AIS patients had all-cause death within the first 12 months. A high level of sST2 at 24 h was associated with MACE in STEMI patients (hazard ratio (HR) = 2.5; 95% confidence interval (CI) [1.1–5.6], p = 0.03) and all-cause death in AIS patients (HR = 11.7; 95% CI [3.8–36.2], p < 0.01) within the first 12 months.

Conclusions

The study highlights that sST2 levels at 24 h are associated with an increased risk to adverse clinical events in both diseases.

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Acknowledgements

The authors would like to thank the Clinical Investigation Center for all the work that has been performed in data collection and management for this study. Human biological samples and associated data were obtained from NeuroBioTec (CRB HCL, Lyon France, Biobank BB-0033-00046). We also thank Joe Kelk for proofreading the English and Murielle Robert for her support.

Funding

This work was supported by the RHU MARVELOUS (ANR-16-RHUS-0009) of Université de Lyon, within the program "Investissements d'Avenir" operated by the French National Research Agency (ANR). AP was supported by the «Fondation pour la recherche médicale» (FDT202012010540).

Author information

Authors and Affiliations

  1. Stroke Center, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France

    Laura Mechtouff, Tae-Hee Cho & Norbert Nighoghossian

  2. CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France

    Laura Mechtouff, Alexandre Paccalet, Claire Crola Da Silva, Nathan Mewton, Eric Bonnefoy-Cudraz, Simon Leboube, Tae-Hee Cho, Norbert Nighoghossian, Michel Ovize & Thomas Bochaton

  3. Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France

    Marielle Buisson, Nathan Mewton, Camille Amaz & Michel Ovize

  4. Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France

    Eric Bonnefoy-Cudraz & Thomas Bochaton

  5. Service d’explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France

    Simon Leboube & Michel Ovize

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  1. Laura Mechtouff
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Corresponding author

Correspondence to Laura Mechtouff.

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The authors declare that they have no conflict of interest.

Ethical standards

The study was approved by the local ethics committee (IRB number: 2015-067B for HIBISCUS-STEMI, IRB number: 00009118 for HIBISCUS-STROKE, CPP Sud-Est III, IRB number: 00009118 for HIBISCUS-STROKE, CPP Sud-Est III) and all subjects or their relatives signed an informed consent form.

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Mechtouff, L., Paccalet, A., Crola Da Silva, C. et al. Prognosis value of serum soluble ST2 level in acute ischemic stroke and STEMI patients in the era of mechanical reperfusion therapy. J Neurol 269, 2641–2648 (2022). https://doi.org/10.1007/s00415-021-10865-3

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  • DOI: https://doi.org/10.1007/s00415-021-10865-3

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