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Serum soluble ST2 is a potential long‐term prognostic biomarker for transient ischaemic attack and ischaemic stroke
Author(s) -
Tian X.,
Guo Y.,
Wang X.,
Pei L.,
Wang X.,
Wu J.,
Sun S.,
Li Y.,
Ning M.,
Buonanno F. S.,
Xu Y.,
Song B.
Publication year - 2020
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14419
Subject(s) - medicine , interquartile range , hazard ratio , ischaemic stroke , proportional hazards model , biomarker , stroke (engine) , confidence interval , prospective cohort study , multivariate analysis , cardiology , gastroenterology , ischemia , mechanical engineering , biochemistry , chemistry , engineering
Background and purpose Soluble ST2 (sST2) is a promising biomarker in inflammation, atherosclerosis and cardiovascular diseases. We investigated the association between serum sST2 and poor outcome in patients with transient ischaemic attack (TIA)/ischaemic stroke. Methods Patients within 24 h after onset and with measured serum sST2 were prospectively enrolled in this study. Poor outcome was a combination of a new stroke event (ischaemic or haemorrhagic) and all‐cause death within 90 days and 1 year. The associations of serum sST2 with poor outcome were analysed by Cox proportional hazards. Results Among the 430 patients included, the median (interquartile range) sST2 was 17.72 (9.31–28.84) ng/mL. A total of 19 (4.4%) and 38 (8.8%) patients experienced poor outcome within 90 days and 1 year, respectively. Compared with the lowest sST2 tertile, hazard ratios (HRs) [95% confidence intervals (CI)] for the highest tertile were 5.14 (1.43–18.51) for poor outcome within 90 days and 3.00 (1.29–6.97) at 1 year after multivariate adjustments. Adding sST2 to a prediction model significantly improved risk stratification of poor outcome in TIA/ischaemic stroke, as observed by the continuous net reclassification improvement of 60.98% (95% CI, 15.37–106.6%, P = 0.009) and integrated discrimination improvement of 2.63% (95% CI, 0.08–5.18%, P = 0.043) at 90 days and the continuous net reclassification improvement of 41.68% (95% CI, 8.74–74.61%, P = 0.013) at 1 year. Conclusions Increased serum sST2 levels in TIA/ischaemic stroke were associated with increased risks of poor outcome within 90 days and 1 year, suggesting that serum sST2 may be a potential long‐term prognostic biomarker for TIA/ischaemic stroke.