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Lack of Superiority for Soluble ST2 over High Sensitive C-Reactive Protein in Predicting High Risk Coronary Artery Calcium Score in a Community Cohort

 Jaewon Oh  ;  Sungha Park  ;  Hee Tae Yu  ;  Hyuk-Jae Chang  ;  Sang-Hak Lee  ;  Seok-Min Kang  ;  Donghoon Choi 
 YONSEI MEDICAL JOURNAL, Vol.57(6) : 1347-1353, 2016 
Journal Title
Issue Date
Aged ; Biomarkers ; C-Reactive Protein/analysis* ; Calcium ; Computed Tomography Angiography ; Coronary Angiography/methods* ; Coronary Artery Disease/diagnostic imaging* ; Coronary Vessels/diagnostic imaging* ; Female ; Humans ; Interleukin-1 Receptor-Like 1 Protein ; Male ; Middle Aged ; Population Surveillance ; Predictive Value of Tests ; Prognosis ; Risk ; Risk Factors ; Tomography, X-Ray Computed ; Vascular Calcification/diagnostic imaging*
Soluble ST2 ; atherosclerosis ; coronary artery calcium score ; high sensitive C-reactive protein
PURPOSE: Soluble ST2 (sST2) is an emerging prognostic biomarker in patients with cardiovascular disease (CVD). A recent study showed that sST2 predicted incident hypertension. High sensitive C-reactive protein (hsCRP) has been a widely-used biomarker for risk-stratifying in CVD. We compared the abilities of sST2 and hsCRP to predict high risk coronary artery calcium score (CACS). MATERIALS AND METHODS: The CACS was assessed by cardiac computed tomography, and sST2 was measured in 456 subjects enrolled in the Mapo-gu community cohort. In accordance with the 2013 ACC/AHA guidelines, we defined the high risk CACS group as individuals with a CACS ≥300 Agatston units (AU). RESULTS: There were 99 (21.7%) subjects with a CACS ≥300 AU. There was a strong correlation between log sST2 and log hsCRP (r=0.128, p=0.006), and both log sST2 and log hsCRP showed significant associations with CACS (r=0.101, p=0.031 for sST2, r=0.101, p=0.032 for hsCRP). In net reclassification improvement (NRI) analysis, the NRI for hsCRP over sST2 was significant [continuous NRI 0.238, 95% confidence interval (CI) 0.001-0.474, integrated discrimination index (IDI) 0.022, p=0.035], while the NRI for sST2 over hsCRP was not significant (continuous NRI 0.212, 95% CI -0.255-0.453, IDI 0.002, p=0.269). CONCLUSION: sST2 does not improve net reclassification for predicting a high risk CACS. Using hsCRP provides superior discrimination and risk reclassification for coronary atherosclerosis, compared with sST2.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Yu, Hee Tae(유희태) ORCID logo https://orcid.org/0000-0002-6835-4759
Lee, Sang Hak(이상학) ORCID logo https://orcid.org/0000-0002-4535-3745
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
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