The value of sST2 in predicting the characteristics of vulnerable plaques in criminals with acute myocardial infarction: a prospective observational study

Abstract

Background: Elevated soluble growth stimulation-expressed gene 2 (sST2) protein levels are associated with poor prognosis in patients with myocardial infarction or heart failure. However, few studies have investigated the association between sST2 expression and plaque stability. This study aimed to investigate the expression of sST2 in patients with acute myocardial infarction and its predictive value for vulnerable plaque characteristics in culprit lesions.

Methods: From October 2022 to December 2024, 230 patients with acute myocardial infarction who underwent coronary angiography and optical coherence tomography (OCT) in (emergency) outpatient and inpatient departments of Jining No.1 People’s Hospital were selected as subjects of this prospective study. Based on the inclusion and exclusion criteria, 203 patients were included in this study. Clinical data were analyzed. Based on the characteristics of criminal plaques detected by OCT, 123 cases were divided into a thin-cap fibroatheroma (TCFA) group (60.6%) and a non-thin-cap fibroatheroma (NTCFA) group (80 cases). Serum sST2 levels were measured before surgery. Optical coherence tomography was used to observe the nature of the criminal lesions before interventional therapy. The relationship between serum sST2 levels and criminal plaque vulnerability was analyzed using a multivariable logistic regression model.

Results: Serum cardiac troponin, C-reactive protein, and sST2 levels were higher in the TCFA group than those in the NTCFA group. OCT observations showed that patients in the TCFA group had many characteristics of vulnerable plaques, including macrophage aggregation, larger lipid radians, and thinner minimum fibrous caps. sST2 independently predicted the presence of TCFA in patients with acute myocardial infarction, with enhanced predictive accuracy when combined with C-reactive protein (area under the curve 0.837 vs. 0.782 for sST2 alone, P = 0.043).Conclusion sST2 can independently predict the presence of thin cap atherosclerosis in patients with acute myocardial infarction, and when combined with C-reactive protein, its prediction accuracy is higher.

Keywords

Soluble growth stimulation expressed gene 2 protein / Acute myocardial infarction / Atherosclerotic plaque of thin fibrous cap / Culprit lesion

Conflict of interest

The authors declare no conflict of interest.

Author contributions

All authors contributed to the study’s conceptualization and design, analysis and interpretation, and participated in drafting and critically revising the manuscript. The final manuscript was approved by all the authors.

Funding

This work was supported by the Medical and Health Science and Technology Projects in Shandong Province (202410000557) and Jining Key Research and Development (2024YXNS171).

Ethical approval of studies and informed consent

The study followed the principles of the Declaration of Helsinki as revised in 2013. The study protocol was approved by the Ethics Committee of Jining No.1 People’s Hospital (Ethics Research No. (12), 2022; April 4, 2022). The personal information of the patients was protected, and all patients signed an informed consent form.

Acknowledgments

None.

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