Biomarkers NT-PROBNP and ST2 in risk stratification of patients with acute myocardial infarction and obesity

Abstract

The aim – to find out the diagnostic value of NT-proBNP and ST2 and to determine their correlations with the development of cardiovascular (CV) complications in patients with ST-elevation myocardial infarction (STEMI) and obesity.Materials and methods. All patients were divided into 3 groups depending on body weight: group I included 52 patients with normal body weight (mean age – 60.83±11.94 years); group II – 51 patients with excess body weight (mean age – 62.04±8.55 years); group III – 55 patients with obesity I–III degree (mean age 60.96±11.31 years). 60 patients were selected in whose serum NT-proBNP and ST2 concentration were additionally determined twice, on admission and on the 10th day of treatment, using the test systems by Biomedica and Presage ST2 assay.Results and discussion. Patients were divided into 2 subgroups depending on the course of the disease: group A – 22 patients with STEMI complicated with acute HF with Killip class III–IV, acute left ventricular aneurysm, rhythm and conductivity disturbances; group B – 38 patients with STEMI without CV complications. At admission to the hospital mean levels of NT-proBNP were higher in patients with CV complications (612.8 [489.5; 860.4] pg/ml – group I) when compared to non CV complications patients (598.6 [326.6; 913.1] pg/ml – group II, p>0.05). On the 10th day of the hospitalization serum levels of NT-proBNP decreased in both groups of patients (р>0.01), regardless of the course of acute myocardial infarction: on 44.52 % – in group A and 68.24 % – in group B. However, it should be noted that the values of NT-proBNP in group A on the 10th day of observation significantly exceeded the corresponding indicators in group B (р>0,05). At admission to the hospital mean ST2 values were significantly higher in patients with diagnosed CV complications (61.1 [44.8; 133.6] ng/ml – A) compared with patients without complications (40.8 [33.1; 64.3] ng/ml – B, р>0.05). When re-determining the ST2 biomarker in both groups of patients there was a significant (р>0.001) decrease: to 23.7 [18.8; 28.3] ng/ml (A) and 24 [19.7; 28.7] ng/ml (B), respectively, without a significant difference between the groups.Conclusions. The biomarker ST2 can be considered as a predictor of cardiovascular complications in patients with STЕMI in the early postinfarction period. NT-proBNP values ​​in patients with complications in the early postinfarction period remain significantly higher on the 10th day of observation compared with those in patients without complications. The presence of obesity worsens the course of STЕMI: in such patients the values ​​of biomarkers NT-proBNP and ST2 are higher and complications are significantly more common in the early post-infarction period.