Prognostic Value of Cardiovascular Risk of sST2 and Troponin I-hs in Patients With Acute Chest Pain

The role of the sST2 biomarker has been widely explored in heart failure, so much so that it was included in the AHA guidelines in 2013 and 2017. Recently, several studies are proposing a role of sST2 in the prognostic stratification of patients with Acute Coronary Syndrome and ischemic heart disease, in association with other biomarkers even proposing a possible therapeutic differentiation. The combined use of sST2 with high-sensitivity troponins could be a promising strategy to identify those patients who, despite having early rule-out after evaluation at the Emergency Department, have a higher risk of onset of cardiovascular events in the medium-long term.

Inclusion Criteria:Age ≥ 18 years;Chest pain of presumable cardiac origin and uncertain etiological diagnosisECG not diagnostic for ischemiatroponin values within normal rangesExclusion Criteria:STEMI myocardial infarctionSepsis and viral infectionsPatients with ECG abnormalities that make it uninterpretable for ischemic purposesPatients with previous coronary eventsHistory of heart failureKnown diagnosis of cardiovascular disease, acute or chronic, including pericarditis, myocarditisConditions involving sST2 elevations unrelated to cardiac causes, particularly acute/chronic inflammatory or fibrotic conditions (inflammatory bowel disease, malignancy, moderate to severe pulmonary fibrosis, chronic liver disease; autoimmune disorders)