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

Fondazione Policlinico Universitario Agostino Gemelli IRCCS100 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

100

Conditions

Acute Chest Pain Acute Coronary Syndrome

Interventions

Multimarker approach in acute coronary syndromeOTHER

The main objective of the study is to evaluate the prognostic role of the biochemical marker sST2 in patients attending the Emergency Department of our hospital with acute chest pain with suspected acute coronary syndrome.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥ 18 years; * Chest pain of presumable cardiac origin and uncertain etiological diagnosis * ECG not diagnostic for ischemia * troponin values within normal ranges Exclusion Criteria: * STEMI myocardial infarction * Sepsis and viral infections * Patients with ECG abnormalities that make it uninterpretable for ischemic purposes * Patients with previous coronary events * History of heart failure * Known diagnosis of cardiovascular disease, acute or chronic, including pericarditis, myocarditis * Conditions 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)

Outcomes

Primary Outcomes

Evaluate sST2 predictive value's

Evaluate the medium-long term (1 year) predictive value of the sST2 biomarker in the heart patients attending at the Emergency Department for non-STEMI Acute Chest Pain.

Time frame: 24 months

Secondary Outcomes

Compare sST2 prognostic value with troponins

Compare the prognostic value of the new biomarker with highly sensitive troponins, for which there is already evidence in the literature

Time frame: 24 months

Create a multiparametric algorithm/score

Integrate the sST2 values in a multiparametric algorithm/score for the differential diagnosis and risk stratification in medium/long-term complications.

Time frame: 36 months