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Soluble ST2 is a Useful Biomarker for Grading Cerebral–Cardiac Syndrome in Patients after Acute Ischemic Stroke

This study tested whether the soluble (s)ST2 is a superb biomarker predictive of moderate to severe cerebral–cardiac syndrome (CCS) (defined as coexisting National Institute of Health Stroke Scale (NIHSS) >8 and left-ventricular ejection fraction (LVEF) <60%) in patients after acute ischemic s...

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Autores principales: Sung, Pei-Hsun, Lin, Hung Sheng, Chen, Kuan-Hung, Chiang, John Y., Ko, Sheung-Fat, Shao, Pei-Lin, Chiang, Hsin-Ju, Chu, Chi-Hsiang, Li, Yi-Chen, Chai, Han-Tan, Lin, Kun-Chen, Yip, Hon-Kan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074380/
https://www.ncbi.nlm.nih.gov/pubmed/32054047
http://dx.doi.org/10.3390/jcm9020489
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author Sung, Pei-Hsun
Lin, Hung Sheng
Chen, Kuan-Hung
Chiang, John Y.
Ko, Sheung-Fat
Shao, Pei-Lin
Chiang, Hsin-Ju
Chu, Chi-Hsiang
Li, Yi-Chen
Chai, Han-Tan
Lin, Kun-Chen
Yip, Hon-Kan
author_facet Sung, Pei-Hsun
Lin, Hung Sheng
Chen, Kuan-Hung
Chiang, John Y.
Ko, Sheung-Fat
Shao, Pei-Lin
Chiang, Hsin-Ju
Chu, Chi-Hsiang
Li, Yi-Chen
Chai, Han-Tan
Lin, Kun-Chen
Yip, Hon-Kan
author_sort Sung, Pei-Hsun
collection PubMed
description This study tested whether the soluble (s)ST2 is a superb biomarker predictive of moderate to severe cerebral–cardiac syndrome (CCS) (defined as coexisting National Institute of Health Stroke Scale (NIHSS) >8 and left-ventricular ejection fraction (LVEF) <60%) in patients after acute ischemic stroke (IS). Between November 2015 and October 2017, a total of 99 IS patients were prospectively enrolled and categorized into three groups based on NIHSS, i.e., group 1 (NIHSS ≤ 8, n = 66), group 2 (NIHSS = 9-15, n = 14) and group 3 (NIHSS ≥ 16, n = 19), respectively. Blood samples were collected immediately after hospitalization, followed by transthoracic echocardiographic examination. The results showed that the flow cytometric analysis for assessment of inflammatory biomarkers of TLR2+/CD14+cells, TLR4+/CD14+cells, Ly6g+/CD14+cells, and MPO+/CD14+cells, and ELISA assessment for circulatory level of sST2 were significantly higher in groups 2/3 than in group 1 (all p < 0.01). However, these parameters did not show significant differences between groups 2 and 3 (all p > 0.05). The LVEF was significantly lower in group 3 than in group 1 (p < 0.001), but it displayed no difference between groups 1/2 or between groups 2/3. These inflammatory biomarkers ((TLR2+/CD14+cells// TLR4+/CD14+cells// MPO+/CD14+cells) and sST2)) were significantly positively correlated to NIHSS and strongly negatively correlated to LVEF (all p < 0.05). Multivariate analysis demonstrated that both MPO/CD14+cells >20% (p = 0.027) and sST2 ≥ 17,600 (p = 0.004) were significantly and independently predictive of moderate-severe CCS after acute IS. Receiver operating characteristic curve analysis demonstrated that sST2 was the most powerful predictor of CCS with a sensitivity of 0.929 and a specificity of 0.731 (p < 0.001). In conclusion, sST2 is a useful biomarker for prediction of CCS severity in patients after acute IS.
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spelling pubmed-70743802020-03-20 Soluble ST2 is a Useful Biomarker for Grading Cerebral–Cardiac Syndrome in Patients after Acute Ischemic Stroke Sung, Pei-Hsun Lin, Hung Sheng Chen, Kuan-Hung Chiang, John Y. Ko, Sheung-Fat Shao, Pei-Lin Chiang, Hsin-Ju Chu, Chi-Hsiang Li, Yi-Chen Chai, Han-Tan Lin, Kun-Chen Yip, Hon-Kan J Clin Med Article This study tested whether the soluble (s)ST2 is a superb biomarker predictive of moderate to severe cerebral–cardiac syndrome (CCS) (defined as coexisting National Institute of Health Stroke Scale (NIHSS) >8 and left-ventricular ejection fraction (LVEF) <60%) in patients after acute ischemic stroke (IS). Between November 2015 and October 2017, a total of 99 IS patients were prospectively enrolled and categorized into three groups based on NIHSS, i.e., group 1 (NIHSS ≤ 8, n = 66), group 2 (NIHSS = 9-15, n = 14) and group 3 (NIHSS ≥ 16, n = 19), respectively. Blood samples were collected immediately after hospitalization, followed by transthoracic echocardiographic examination. The results showed that the flow cytometric analysis for assessment of inflammatory biomarkers of TLR2+/CD14+cells, TLR4+/CD14+cells, Ly6g+/CD14+cells, and MPO+/CD14+cells, and ELISA assessment for circulatory level of sST2 were significantly higher in groups 2/3 than in group 1 (all p < 0.01). However, these parameters did not show significant differences between groups 2 and 3 (all p > 0.05). The LVEF was significantly lower in group 3 than in group 1 (p < 0.001), but it displayed no difference between groups 1/2 or between groups 2/3. These inflammatory biomarkers ((TLR2+/CD14+cells// TLR4+/CD14+cells// MPO+/CD14+cells) and sST2)) were significantly positively correlated to NIHSS and strongly negatively correlated to LVEF (all p < 0.05). Multivariate analysis demonstrated that both MPO/CD14+cells >20% (p = 0.027) and sST2 ≥ 17,600 (p = 0.004) were significantly and independently predictive of moderate-severe CCS after acute IS. Receiver operating characteristic curve analysis demonstrated that sST2 was the most powerful predictor of CCS with a sensitivity of 0.929 and a specificity of 0.731 (p < 0.001). In conclusion, sST2 is a useful biomarker for prediction of CCS severity in patients after acute IS. MDPI 2020-02-11 /pmc/articles/PMC7074380/ /pubmed/32054047 http://dx.doi.org/10.3390/jcm9020489 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sung, Pei-Hsun
Lin, Hung Sheng
Chen, Kuan-Hung
Chiang, John Y.
Ko, Sheung-Fat
Shao, Pei-Lin
Chiang, Hsin-Ju
Chu, Chi-Hsiang
Li, Yi-Chen
Chai, Han-Tan
Lin, Kun-Chen
Yip, Hon-Kan
Soluble ST2 is a Useful Biomarker for Grading Cerebral–Cardiac Syndrome in Patients after Acute Ischemic Stroke
title Soluble ST2 is a Useful Biomarker for Grading Cerebral–Cardiac Syndrome in Patients after Acute Ischemic Stroke
title_full Soluble ST2 is a Useful Biomarker for Grading Cerebral–Cardiac Syndrome in Patients after Acute Ischemic Stroke
title_fullStr Soluble ST2 is a Useful Biomarker for Grading Cerebral–Cardiac Syndrome in Patients after Acute Ischemic Stroke
title_full_unstemmed Soluble ST2 is a Useful Biomarker for Grading Cerebral–Cardiac Syndrome in Patients after Acute Ischemic Stroke
title_short Soluble ST2 is a Useful Biomarker for Grading Cerebral–Cardiac Syndrome in Patients after Acute Ischemic Stroke
title_sort soluble st2 is a useful biomarker for grading cerebral–cardiac syndrome in patients after acute ischemic stroke
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074380/
https://www.ncbi.nlm.nih.gov/pubmed/32054047
http://dx.doi.org/10.3390/jcm9020489
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