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Soluble ST2 is associated with postoperative atrial fibrillation after cardiac surgery in postmenopausal women
Andreas Hammer1, Frieda Marka1, Ulrike Baumer2
1Division of Cardiology, Dept. of Internal Medicine II. Medical University of Vienna, Austria; Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria.
Insights
Soluble ST2 (sST2) predicts postoperative atrial fibrillation (POAF) in women undergoing cardiac surgery. Higher sST2 levels correlate with longer POAF duration, suggesting its utility in risk stratification.
Area of Science:
- Cardiology
- Biomarkers
- Cardiac Surgery
Background:
- Postoperative atrial fibrillation (POAF) is a common cardiac surgery complication.
- A significant portion of POAF patients develop persistent atrial fibrillation.
- The predictive role of soluble ST2 (sST2) for POAF onset is not well-established.
Purpose of the Study:
- To investigate the association between preoperative sST2 levels and the incidence of POAF.
- To determine if sST2 can predict POAF development in patients undergoing elective cardiac surgery.
- To explore the relationship between sST2 levels and POAF duration.
Main Methods:
- Preoperative sST2 levels were measured in 496 patients without a history of AF undergoing elective cardiac surgery.
- Patients included those having valve, coronary artery bypass graft, or combined procedures.
- Statistical analyses, including logistic regression and linear regression, were used to assess the predictive value of sST2.
Main Results:
- 42.3% of patients developed POAF.
- Preoperative sST2 levels were significantly higher in patients who developed POAF.
- sST2 predicted POAF in women (OR 1.894) but not in men (OR 1.091).
- Each 1 ng/mL increase in sST2 correlated with an additional 39.5 minutes of POAF duration.
Conclusions:
- Preoperative sST2 levels can predict the onset of POAF in women undergoing cardiac surgery.
- sST2 levels are associated with the overall burden (duration) of POAF.
- Incorporating sST2 assessment with existing risk factors may enhance POAF risk stratification.
Background:
Postoperative atrial fibrillation (POAF) represents the most common complication following cardiac surgery. Approximately one-third of patients experiencing POAF transition to atrial fibrillation within a year, challenging the notion of POAF as merely a transient event. Soluble ST2 (sST2) is an established biomarker regarding fibrosis and myocardial stretch, however, its role in predicting the onset of POAF remains unclear.
Methods:
Preoperative sST2 levels have been assessed in 496 individuals with no prior history of AF who underwent elective cardiac surgery, including valve, coronary artery bypass graft surgery, or a combined procedure.
Results:
The average age was 70 years, and 29.4 % were female. Overall, 42.3 % developed POAF. sST2 levels were found to be significantly higher in patients with POAF. Interestingly, sST2 was only predictive of POAF in females with an adjusted OR of 1.894 (95 %CI:1.103-3.253; p = 0.021) and not males (OR:1.091; 95 %CI:0.849-1.402; p = 0.495). Furthermore, within a linear regression model it was observed that for every 1 ng/mL increase in sST2 levels, the average POAF duration extended by 39.5 min (95 %CI:15.8-63.4 min; p = 0.001).
Conclusion:
sST2 predicts the onset of POAF in women but not men undergoing cardiac surgery. Furthermore, sST2 levels were associated with the subsequent burden of POAF. Thus, assessment of sST2 in addition to clinical risk factors could improve risk stratification for development of POAF following elective cardiac surgery.
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