Abstract
Background Heart failure is shown to be associated with elevated levels of ST2 levels in blood. The data about the relation of blood ST2 levels, in patients of significant coronary artery disease (CAD) with left ventricular (LV) dysfunction is limited. The impact of gender on ST2 levels not studied until now, so this study aimed to assess the blood ST2 levels measured for males and females patients in comparisons, of CAD with LV dysfunction and their relation to the outcomes at the end of 1-year post intervention.
Material and Methods Out of the 60 patients with 1:2 ratio of females and males with CAD and LV dysfunction, baseline quantitative assessment of ST2 levels in blood was done by rapid lateral flow immunoassay method; > 35 mg/mL was considered as abnormal. Postintervention patients followed up to one year, adverse cardiovascular events noted at the end of 1 year. By using binary logistic regression, the outcomes in females compared with males for statistical significance in relation to baseline blood ST 2 levels. The p value of < 0.05 considered was significant.
Results Among the 60 patients (females 33.3% and males 66.6 %) presented with CAD with LV dysfunction in the study, 40 (66.6 %) patients diagnosed of acute coronary syndrome (ACS), and 20 (33.3%) patients with chronic stable angina (CSA). In both the genders, ACS is most common presentation (55% in females and 72.5 % in males). Eighteen (90%) females and 20 (50%) males were hypertensive, 12 (60%) females and 18 (45%) males were diabetics. Twenty-seven (67.5%) males were smokers and 14 (35%) were alcoholics. Nine (45%) female and 14 (35%) male patients had elevated ST2 levels. At the end of 1 year 9 females had events including 2 mortalities, 2 heart failures, and 7 repeat revascularizations. At the same time 7 male patients had events at the end of 1 year including 4 mortalities, 5 heart failures, and 2 repeat revascularizations. The difference in the event rates between male and female patients were statistically significance (p = 0.03). Elevated ST2 levels were correlated with echocardiographic parameter end systolic volume which was statistically significant (p= 0.03). Similarly elevated ST2 levels correlated with presence of diabetes (p= 0.01) and low LV EF.
Conclusion Mean Blood ST2 levels were higher in females who associated with diabetes, high echo cardio graphic end-systolic volume, and a low ejection fraction of LV in severe LV dysfunction with statistical significance. At the end of 1 year in patients with elevated baseline ST2 levels, the female patient had more events than males with statistical significance.
Scintigraphic study of relation between left ventricular peak systolic pressure and end-systolic volume in patients with coronary artery disease and normal subjects.