Soluble ST2 in Patients with Carotid Artery Stenosis—Association with Plaque Morphology and Long-Term Outcome
Interleukin (IL-33) and the ST2 receptor are implicated in the pathogenesis of atherosclerosis. Soluble ST2 (sST2), which negatively regulates IL-33 signaling, is an established biomarker in coronary artery disease and heart failure. Here we aimed to investigate the association of sST2 with carotid...
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MDPI AG
2023-05-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/10/9007 |
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| author | Stefan Stojkovic Stephanie Kampf Olesya Harkot Maja Nackenhorst Mira Brekalo Kurt Huber Christian Hengstenberg Christoph Neumayer Johann Wojta Svitlana Demyanets |
| author_facet | Stefan Stojkovic Stephanie Kampf Olesya Harkot Maja Nackenhorst Mira Brekalo Kurt Huber Christian Hengstenberg Christoph Neumayer Johann Wojta Svitlana Demyanets |
| author_sort | Stefan Stojkovic |
| collection | DOAJ |
| description | Interleukin (IL-33) and the ST2 receptor are implicated in the pathogenesis of atherosclerosis. Soluble ST2 (sST2), which negatively regulates IL-33 signaling, is an established biomarker in coronary artery disease and heart failure. Here we aimed to investigate the association of sST2 with carotid atherosclerotic plaque morphology, symptom presentation, and the prognostic value of sST2 in patients undergoing carotid endarterectomy. A total of 170 consecutive patients with high-grade asymptomatic or symptomatic carotid artery stenosis undergoing carotid endarterectomy were included in the study. The patients were followed up for 10 years, and the primary endpoint was defined as a composite of adverse cardiovascular events and cardiovascular mortality, with all-cause mortality as the secondary endpoint. The baseline sST2 showed no association with carotid plaque morphology assessed using carotid duplex ultrasound (B 0.051, 95% CI −0.145–0.248, <i>p</i> = 0.609), nor with modified histological AHA classification based on morphological description following surgery (B −0.032, 95% CI −0.194–0.130, <i>p</i> = 0.698). Furthermore, sST2 was not associated with baseline clinical symptoms (B −0.105, 95% CI −0.432–0.214, <i>p</i> = 0.517). On the other hand, sST2 was an independent predictor for long-term adverse cardiovascular events after adjustment for age, sex, and coronary artery disease (HR 1.4, 95% CI 1.0–2.4, <i>p</i> = 0.048), but not for all-cause mortality (HR 1.2, 95% CI 0.8–1.7, <i>p</i> = 0.301). Patients with high baseline sST2 levels had a significantly higher adverse cardiovascular event rate as compared to patients with lower sST2 (log-rank <i>p</i> < 0.001). Although IL-33 and ST2 play a role in the pathogenesis of atherosclerosis, sST2 is not associated with carotid plaque morphology. However, sST2 is an excellent prognostic marker for long-term adverse cardiovascular outcomes in patients with high-grade carotid artery stenosis. |
| first_indexed | 2024-03-11T03:39:01Z |
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| id | doaj.art-de6c4db0d24f4562969465e20d56f576 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-11T03:39:01Z |
| publishDate | 2023-05-01 |
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| spelling | doaj.art-de6c4db0d24f4562969465e20d56f5762023-11-18T01:45:46ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-05-012410900710.3390/ijms24109007Soluble ST2 in Patients with Carotid Artery Stenosis—Association with Plaque Morphology and Long-Term OutcomeStefan Stojkovic0Stephanie Kampf1Olesya Harkot2Maja Nackenhorst3Mira Brekalo4Kurt Huber5Christian Hengstenberg6Christoph Neumayer7Johann Wojta8Svitlana Demyanets9Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 1090 Vienna, AustriaDepartment of General Surgery, Division of Vascular Surgery, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Pathology, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria3rd Medical Department with Cardiology and Intensive Care Medicine, Klinik Ottakring, 1160 Vienna, AustriaDepartment of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 1090 Vienna, AustriaDepartment of General Surgery, Division of Vascular Surgery, Medical University of Vienna, 1090 Vienna, AustriaLudwig Boltzmann Institute for Cardiovascular Research, 1090 Vienna, AustriaDepartment of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, AustriaInterleukin (IL-33) and the ST2 receptor are implicated in the pathogenesis of atherosclerosis. Soluble ST2 (sST2), which negatively regulates IL-33 signaling, is an established biomarker in coronary artery disease and heart failure. Here we aimed to investigate the association of sST2 with carotid atherosclerotic plaque morphology, symptom presentation, and the prognostic value of sST2 in patients undergoing carotid endarterectomy. A total of 170 consecutive patients with high-grade asymptomatic or symptomatic carotid artery stenosis undergoing carotid endarterectomy were included in the study. The patients were followed up for 10 years, and the primary endpoint was defined as a composite of adverse cardiovascular events and cardiovascular mortality, with all-cause mortality as the secondary endpoint. The baseline sST2 showed no association with carotid plaque morphology assessed using carotid duplex ultrasound (B 0.051, 95% CI −0.145–0.248, <i>p</i> = 0.609), nor with modified histological AHA classification based on morphological description following surgery (B −0.032, 95% CI −0.194–0.130, <i>p</i> = 0.698). Furthermore, sST2 was not associated with baseline clinical symptoms (B −0.105, 95% CI −0.432–0.214, <i>p</i> = 0.517). On the other hand, sST2 was an independent predictor for long-term adverse cardiovascular events after adjustment for age, sex, and coronary artery disease (HR 1.4, 95% CI 1.0–2.4, <i>p</i> = 0.048), but not for all-cause mortality (HR 1.2, 95% CI 0.8–1.7, <i>p</i> = 0.301). Patients with high baseline sST2 levels had a significantly higher adverse cardiovascular event rate as compared to patients with lower sST2 (log-rank <i>p</i> < 0.001). Although IL-33 and ST2 play a role in the pathogenesis of atherosclerosis, sST2 is not associated with carotid plaque morphology. However, sST2 is an excellent prognostic marker for long-term adverse cardiovascular outcomes in patients with high-grade carotid artery stenosis.https://www.mdpi.com/1422-0067/24/10/9007carotid artery diseasesoluble suppression of tumorigenesis 2 (sST2)prognostic biomarker |
| spellingShingle | Stefan Stojkovic Stephanie Kampf Olesya Harkot Maja Nackenhorst Mira Brekalo Kurt Huber Christian Hengstenberg Christoph Neumayer Johann Wojta Svitlana Demyanets Soluble ST2 in Patients with Carotid Artery Stenosis—Association with Plaque Morphology and Long-Term Outcome International Journal of Molecular Sciences carotid artery disease soluble suppression of tumorigenesis 2 (sST2) prognostic biomarker |
| title | Soluble ST2 in Patients with Carotid Artery Stenosis—Association with Plaque Morphology and Long-Term Outcome |
| title_full | Soluble ST2 in Patients with Carotid Artery Stenosis—Association with Plaque Morphology and Long-Term Outcome |
| title_fullStr | Soluble ST2 in Patients with Carotid Artery Stenosis—Association with Plaque Morphology and Long-Term Outcome |
| title_full_unstemmed | Soluble ST2 in Patients with Carotid Artery Stenosis—Association with Plaque Morphology and Long-Term Outcome |
| title_short | Soluble ST2 in Patients with Carotid Artery Stenosis—Association with Plaque Morphology and Long-Term Outcome |
| title_sort | soluble st2 in patients with carotid artery stenosis association with plaque morphology and long term outcome |
| topic | carotid artery disease soluble suppression of tumorigenesis 2 (sST2) prognostic biomarker |
| url | https://www.mdpi.com/1422-0067/24/10/9007 |
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