Abstract |
Acute aortic syndromes (AASs) are difficult to diagnose emergencies. Plasma soluble ST2 (sST2), a prognostic biomarker for heart failure, has been proposed as a diagnostic biomarker of AASs outperforming D-dimer, the current diagnostic standard. We performed a prospective diagnostic accuracy study of sST2 for AASs in the Emergency Department (ED). In 2017-2018, patients were enrolled if they had ≥1 red-flag symptoms (chest/abdominal/ back pain, syncope, perfusion deficit) and a clinical suspicion of AAS. sST2 was detected with the Presage® assay. Adjudication was based on computed tomography angiography (CTA) or on diagnostic outcome inclusive of 30-day follow-up. 297 patients were enrolled, including 88 with AASs. The median age was 67 years. In 162 patients with CTA, the median sST2 level was 41.7 ng/mL (IQR 29.4-103.2) in AASs and 34.6 ng/mL (IQR 21.4-51.5) in alternative diagnoses (P = 0.005). In ROC analysis, the AUC of sST2 was 0.63, as compared to 0.82 of D-dimer (P < 0.001). Sensitivity and specificity values of sST2 associated with different cutoffs were: 95.5% and 10.8% (≥12 ng/mL), 84.1% and 29.7% (≥23.7 ng/mL), 35.2% and 85.1% (≥66.5 ng/mL). Results were similar in the full cohort. In conclusion, in patients from a European ED, plasma sST2 provided modest accuracy for diagnosis of AASs.
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Authors | Fulvio Morello, Alice Bartalucci, Marco Bironzo, Marco Santoro, Emanuele Pivetta, Alice Ianniello, Francesca Rumbolo, Giulio Mengozzi, Enrico Lupia |
Journal | Scientific reports
(Sci Rep)
Vol. 10
Issue 1
Pg. 3103
(02 20 2020)
ISSN: 2045-2322 [Electronic] England |
PMID | 32080259
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers
- Fibrin Fibrinogen Degradation Products
- IL1RL1 protein, human
- Interleukin-1 Receptor-Like 1 Protein
- fibrin fragment D
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Topics |
- Aged
- Aged, 80 and over
- Aortic Dissection
(blood, diagnosis)
- Aortic Aneurysm
(blood, diagnosis)
- Area Under Curve
- Biomarkers
(blood)
- Cardiology
(standards)
- Female
- Fibrin Fibrinogen Degradation Products
(analysis)
- Humans
- Interleukin-1 Receptor-Like 1 Protein
(blood)
- Male
- Middle Aged
- Prognosis
- Prospective Studies
- ROC Curve
- Reproducibility of Results
- Risk Factors
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