Yonsei Med J.  2016 Nov;57(6):1347-1353. 10.3349/ymj.2016.57.6.1347.

Lack of Superiority for Soluble ST2 over High Sensitive C-Reactive Protein in Predicting High Risk Coronary Artery Calcium Score in a Community Cohort

• Oh J
• Park S
• Yu HT
• Chang HJ
• Lee SH
• Kang SM
• Choi D

• KMID: 2427151
• DOI: http://doi.org/10.3349/ymj.2016.57.6.1347

Abstract

PURPOSE
Soluble ST2 (sST2) is an emerging prognostic biomarker in patients with cardiovascular disease (CVD). A recent study showed that sST2 predicted incident hypertension. High sensitive C-reactive protein (hsCRP) has been a widely-used biomarker for risk-stratifying in CVD. We compared the abilities of sST2 and hsCRP to predict high risk coronary artery calcium score (CACS).
MATERIALS AND METHODS
The CACS was assessed by cardiac computed tomography, and sST2 was measured in 456 subjects enrolled in the Mapo-gu community cohort. In accordance with the 2013 ACC/AHA guidelines, we defined the high risk CACS group as individuals with a CACS ≥300 Agatston units (AU).
RESULTS
There were 99 (21.7%) subjects with a CACS ≥300 AU. There was a strong correlation between log sST2 and log hsCRP (r=0.128, p=0.006), and both log sST2 and log hsCRP showed significant associations with CACS (r=0.101, p=0.031 for sST2, r=0.101, p=0.032 for hsCRP). In net reclassification improvement (NRI) analysis, the NRI for hsCRP over sST2 was significant [continuous NRI 0.238, 95% confidence interval (CI) 0.001-0.474, integrated discrimination index (IDI) 0.022, p=0.035], while the NRI for sST2 over hsCRP was not significant (continuous NRI 0.212, 95% CI -0.255-0.453, IDI 0.002, p=0.269).
CONCLUSION
sST2 does not improve net reclassification for predicting a high risk CACS. Using hsCRP provides superior discrimination and risk reclassification for coronary atherosclerosis, compared with sST2.

Keyword

Soluble ST2; high sensitive C-reactive protein; coronary artery calcium score; atherosclerosis

MeSH Terms

Aged
Biomarkers
C-Reactive Protein/*analysis
Calcium
Computed Tomography Angiography
Coronary Angiography/*methods
Coronary Artery Disease/*diagnostic imaging
Coronary Vessels/*diagnostic imaging
Female
Humans
Interleukin-1 Receptor-Like 1 Protein
Male
Middle Aged
Population Surveillance
Predictive Value of Tests
Prognosis
Risk
Risk Factors
Tomography, X-Ray Computed
Vascular Calcification/*diagnostic imaging
Biomarkers
Interleukin-1 Receptor-Like 1 Protein
C-Reactive Protein
Calcium

Figure

• 

  Fig. 1 Mean differences in sST2 (A) and hsCRP (B) between the low and high coronary artery calcium score groups (<300 Agatston units vs. ≥300 Agatston units). *Means p value <0.01 by Mann-Whitney U test between low and high CACS group. sST2, soluble ST2; hsCRP, high sensitive C-reactive protein; CACS; coronary artery calcium score.

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