ST2 is known to be heightened in the early phase after myocardial infarction, and associated with left ventricular remodeling (LVR).

Explore the potential role of ST2 as a predictor for late LVR.

Patients with a reperfused ST-segment elevation myocardial infarction (STEMI) were included in a prospective cohort. They underwent cardiac magnetic resonance (CMR) at 3 days (baseline), 3 and 12 months. Among 163 patients, 33 presented LVR as defined as a 10% change in LV end-systolic volume during follow-up. All patients were matched to 33 STEMI patients without LVR (non-remodelers) in term of age, gender, anterior infarction, baseline LV ejection fraction (LVEF) and infarct size. Early LVR (n=15) was defined as LVR occurring between baseline and 3 months, and Late LVR (n=18) as LVR occurring between 3 and 12 months. Usual CMR parameters were measured, so as global systolic wall stress (SWS). A biomarker analysis was performed at baseline and 3 months.

Patients were 57±10 years old, 85% were male. Early LVR patients presented with mean LVEF and infarct size of 48±10.4% and 28±15.6% LV; and Late LVR with 51±11% and 16±14.5% LV, respectively. At baseline, ST2 (46±54.1ng/mL), NT-proBNP (869±1702ng/L) and SWS (16.2±7.1 10³N·m⁻²) were not different among the groups. At 3 months, Early LVR patients presented higher ST2, NT-proBNP and SWS (26±12.7ng/mL, 652±1069ng/L, 23±9.7 10³N·m⁻² for Early LVR, versus 21±8.6ng/mL, 354±272.8ng/L, 18±7.3 10³N·m⁻² for the corresponding non-remodelers, with P=0.017, 0.040, and 0.036, respectively). Late LVR patients presented higher ST2 at 3 months than non-remodelers (34.4±15.9 versus 22.1±8.7ng/mL, P=0.046), while NT-proBNP and SWS were not different between groups at both time points (Fig. 1).

ST2 can be useful to predict LVR after STEMI.