Serum Soluble ST2 and Plaque Vulnerability in Patients With Acute Coronary Syndrome

Study Overview
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Brief Summary
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This study aimed to assess the association between serum sST2 level and plaque vulnerability in ACS patients. It is hypothesized that serum sST2 level may be related to plaque components and closely associated with plaque vulnerability.

Detailed Description
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Serum soluble suppression of tumorigenicity-2 (sST2) has emerged as a novel biomarker of atherosclerotic disease. This study aimed to investigate whether elevated serum sST2 level is related to coronary plaque components detected on coronary computed tomography angiography (CCTA) and plaque vulnerability in non-ST elevation acute coronary syndromes (ACS) patients. 167 lesions in 120 non-ST elevation ACS patients were prospectively enrolled and evaluated by CCTA in this study. Blood were taken from antecubital vein during patient's hospitalization for angiography. Serum sST2 level was measured by commerical ELISA kits (Presage ST2 Assay Kit, Critical Diagnostics). CCTA were performed using a 320-slice CT scanner (Aquilion ONE, Toshiba Medical Systems, Otawara, Japan). Coronary plaque components were analyzed cross each of the lesions using commercialized software package (QAngio CT, Medis, The Netherlands).

Official Title
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Elevated Serum Soluble ST2 Level is Associated With Increased Plaque Vulnerability in Patients With Non-ST Elevation Acute Coronary Syndrome

Conditions
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Acute Coronary Syndrome

Intervention / Treatment
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* Diagnostic Test: Coronary plaque components


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of non-ST-elevation ACS Non-ST-elevation myocardial infarction Unstable angina Age from 18 to 75 years Underwent CCTA Exclusion Criteria: Patients needed an immediate (< 2 h) or early invasive strategy (< 24 h) according to guidelines: Haemodynamic instability Cardiogenic shock Life-threatening arrhythmias or cardiac arrest Mechanical complication Acute heart failure Dynamic ST or T wave changes GRACE score > 140 Patients with previous history of: Coronary artery bypass graft surgery or percutaneous coronary intervention (PCI) Immune system disorder Tumor Acute/chronic infection Statin use within 3 months Atrial fibrillation End-stage renal failure Iodine-containing contrast allergy Patients with no significant (≥ 50%) stenosis on major epicardial vessels after CCTA performance Patients refused subsequent angiography after CCTA performance Patients with total obstruction on major epicardial vessel Patients with insufficient image quality for QAngioCT analysis

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Serum sST2 level < 14.5 ng/mL<br> | Diagnostic Test: Coronary plaque components<br>* Coronary plaque components were detected by CCTA method<br>|
| 14.5 ng/mL ≤ Serum sST2 level < 20.5 ng/mL<br> | Diagnostic Test: Coronary plaque components<br>* Coronary plaque components were detected by CCTA method<br>|
| 20.5 ng/mL ≤ Serum sST2 level < 25.9 ng/mL<br> | Diagnostic Test: Coronary plaque components<br>* Coronary plaque components were detected by CCTA method<br>|
| Serum sST2 level ≥ 25.9 ng/mL<br> | Diagnostic Test: Coronary plaque components<br>* Coronary plaque components were detected by CCTA method<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Distribution of plaque components by QAngioCT | Hounsfield unit (HU) -30 to 75 for necrotic core, HU 76-130 for fibrous fatty, HU 131-350 for fibrous tissue, and HU over 351 for dense calcium. | Procedure (Coronary CTA ) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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soluble ST2, plaque vulnerability