title: Comparison Between Soluble ST2 and High-Sensitivity Troponin I in Predicting Short-Term Mortality for Patients Presenting to the Emergency Department With Chest Pain.
abstract: BACKGROUND
  High-sensitivity cardiac troponin I (hs-cTnI) and the soluble isoform of suppression of tumorigenicity 2 (sST2) are useful prognostic biomarkers in acute coronary syndrome (ACS). The aim of this study was to test the short term prognostic value of sST2 compared with hs-cTnI in patients with chest pain.
  
  
  METHODS
  Assays for hs-cTnI and sST2 were performed in 157 patients admitted to the Emergency Department (ED) for chest pain at arrival. In-hospital and 30-day follow-up mortalities were assessed.
  
  
  RESULTS
  The incidence of ACS was 37%; 33 patients were diagnosed with ST elevation myocardial infarction (STEMI), and 25 were diagnosed with non-ST elevation myocardial infarction (NSTEMI). Compared with the no acute coronary syndrome (NO ACS) group, the median level of hs-cTnI was higher in ACS patients: 7.22 (5.24-14) pg/mL vs 68 (15.33-163.50) pg/mL (P<0.0001). In all patients, the sST2 level at arrival showed higher independent predictive power than hs-cTnI (odds ratio [OR] 20.13, P<0.0001 and OR 2.61, P<0.0008, respectively). sST2 at ED arrival showed a greater prognostic value for cardiovascular events in STEMI (area under the curve [AUC] 0.80, P<0.001) than NSTEMI patients (AUC 0.72, P<0.05). Overall, 51% of the STEMI patients with an sST2 value>35 ng/mL at ED arrival died during the 30-day follow-up.
  
  
  CONCLUSIONS
  sST2 has a greater prognostic value for 30-day cardiac mortality after discharge in patients presenting to the ED for chest pain compared with hs-cTnI. In STEMI patients, an sST2 value >35 ng/mL at ED arrival showed the highest predictive power for short-term mortality.
authors.affiliation: Department of Medical-Surgery Sciences and Translational Medicine, University Sapienza Rome, Sant' Andrea Hospital, Rome, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Marino
authors.affiliation: Department of Medical-Surgery Sciences and Translational Medicine, University Sapienza Rome, Sant' Andrea Hospital, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Magrini
authors.affiliation: Department of Medical-Surgery Sciences and Translational Medicine, University Sapienza Rome, Sant' Andrea Hospital, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Orsini
authors.affiliation: Department of Medical-Surgery Sciences and Translational Medicine, University Sapienza Rome, Sant' Andrea Hospital, Rome, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Russo
authors.affiliation: Clinical and Molecular Medicine Department, Sant' Andrea Hospital, School of Medicine and Psychology, "Sapienza" University, Rome, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cardelli
authors.affiliation: Clinical and Molecular Medicine Department, Sant' Andrea Hospital, School of Medicine and Psychology, "Sapienza" University, Rome, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Salerno
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Konkuk University, Seoul, Korea.
authors.forename: Mina
authors.initials: M
authors.lastname: Hur
authors.affiliation: Department of Medical-Surgery Sciences and Translational Medicine, University Sapienza Rome, Sant' Andrea Hospital, Rome, Italy. salvatore.disomma@uniroma1.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Somma
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality*; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000032:analysis; D002637:Chest Pain; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D012372:ROC Curve; D019210:Troponin I / Q000032:analysis*
chemical_list: D015415:Biomarkers; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D019210:Troponin I
keywords: 30 day mortality; Acute coronary syndrome; Chest pain; Emergency Department; Prognosis; hs-cTnI; sST2