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Sex and age differences in sST2 in cardiovascular disease
Danielle J Beetler1,2,3, Katelyn A Bruno1,4, Damian N Di Florio1,2,3
1Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States.
Insights
Sex and age significantly impact soluble ST2 (sST2) levels in myocarditis, cardiomyopathy, and myocardial infarction. These differences were not observed in coronary artery disease or congestive heart failure, suggesting further research is needed for specific cardiovascular diseases.
Area of Science:
- Cardiology
- Biomarkers
- Immunology
Background:
- Soluble ST2 (sST2) is a biomarker implicated in cardiovascular diseases (CVDs).
- Understanding demographic variations in sST2 levels is crucial for accurate CVD assessment.
Purpose of the Study:
- To investigate potential sex and age differences in serum sST2 levels across various cardiovascular conditions.
- To compare sST2 levels in patients with specific CVDs against a control group.
Main Methods:
- Serum sST2 levels were quantified using ELISA in patients with myocarditis, cardiomyopathy, coronary artery disease (CAD), myocardial infarct (MI), and congestive heart failure (CHF).
- Patient cohorts were compared to a control group without CVDs.
- Statistical analyses were performed to identify significant differences based on sex and age.
Main Results:
- Serum sST2 levels were significantly elevated in all studied CVDs compared to controls.
- Sex and age differences in sST2 were observed in myocarditis, cardiomyopathy, and MI, but not in CAD or CHF.
- Specific findings include higher sST2 in males for myocarditis and cardiomyopathy, and age-related differences in women with myocarditis and men with cardiomyopathy and MI.
Conclusions:
- Sex and age are significant factors influencing sST2 levels in myocarditis, cardiomyopathy, and MI.
- These demographic variations were not evident in CAD and CHF.
- Further research is warranted to elucidate the role of sex and age in sST2 levels within specific cardiovascular disease contexts.
Aims:
The goal of this study was to determine whether sex and age differences exist for soluble ST2 (sST2) for several cardiovascular diseases (CVDs).
Methods:
We examined sST2 levels using an ELISA kit for myocarditis (n = 303), cardiomyopathy (n = 293), coronary artery disease (CAD) (n = 239), myocardial infarct (MI) (n = 159), and congestive heart failure (CHF) (n = 286) and compared them to controls that did not have CVDs (n = 234).
Results:
Myocarditis occurred in this study in relatively young patients around age 40 while the other CVDs occurred more often in older individuals around age 60. We observed a sex difference in sST2 by age only in myocarditis patients (men aged 38, women 46, p = 0.0002), but not for other CVDs. Sera sST2 levels were significantly elevated compared to age-matched controls for all CVDs: myocarditis (p ≤ 0.0001), cardiomyopathy (p = 0.0009), CAD (p = 0.03), MI (p = 0.034), and CHF (p < 0.0001) driven by elevated sST2 levels in females for all CVDs except myocarditis, which was elevated in both females (p = 0.002) and males (p ≤ 0.0001). Sex differences in sST2 levels were found for myocarditis and cardiomyopathy but no other CVDs and were higher in males (myocarditis p = 0.0035; cardiomyopathy p = 0.0047). sST2 levels were higher in women with myocarditis over 50 years of age compared to men (p = 0.0004) or women under 50 years of age (p = 0.015). In cardiomyopathy and MI patients, men over 50 had significantly higher levels of sST2 than women (p = 0.012 and p = 0.043, respectively) but sex and age differences were not detected in other CVDs. However, women with cardiomyopathy that experienced early menopause had higher sST2 levels than those who underwent menopause at a natural age range (p = 0.02).
Conclusion:
We found that sex and age differences in sera sST2 exist for myocarditis, cardiomyopathy, and MI, but were not observed in other CVDs including CAD and CHF. These initial findings in patients with self-reported CVDs indicate that more research is needed into sex and age differences in sST2 levels in individual CVDs.
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