SMOKING-DEPENDENT RELATIONSHIP BETWEEN SST2 AND NT-PROBNP LEVELS AND RENAL FUNCTION IN ACUTE CORONARY SYNDROME
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i4.14870Keywords:
acute coronary syndrome, chronic kidney disease, glomerular filtration rate, smoking, sST2, NT-proBNP, heart failureAbstract
SUMMARY. The aim – to analyze the smoking-dependent relationship between the levels of the soluble growth stimulation expressed gene 2 (sST2), the N-terminal pro-brain natriuretic peptide (NT-proBNP), and renal function in acute coronary syndrome (ACS).
Material and Methods. The study included 142 patients with ACS aged 35 to 75 (mean age – 59.68±0.81 years). The renal function was measured by the GFR and all patients were divided into two groups. Group I included 57 patients with GFR <60 ml/min/1.73m2; Group II included 85 patients with GFR ≥60 ml/min/1.73m2. The patients of both groups were divided into two subgroups based on their smoking status: А – smokers (I А and II А) and B – non-smokers (I B and II B).
Results. Mean sST2 (by 1.36 times) and NT-proBNP (by 3.27 times) levels were significantly higher in Group I patients compared to Group II patients. Mean sST2 and NT-proBNP levels were also significantly higher in the subgroups of smokers (I А and II А) compared to non-smokers (I B and II B): in I А subgroup compared to I B subgroup, the sST2 levels were 1.56 times higher and NT-proBNP levels were 2.35 times higher, respectively; in II А subgroup, compared to II B subgroup, the sST2 levels were 1.65 times higher and NT-proBNP levels were 3.18 times higher, respectively.
When distributing patients according to sST2 and NT-proBNP levels, in Group I patients compared to Group II, as well as in smokers (I А, II А) compared to non-smokers (I B, II B), 11-35 % significantly lower proportion of patients with sST2 levels <35 ng/ml was recorded, with a higher proportion of patients with sST2 >70 ng/ml; in terms of NT-proBNP level, 18-33 % significantly lower proportion of patients with NT-proBNP <125 ng/l was recorded, with a higher proportion of patients with NT-proBNP >600 ng/l.
When analyzing the correlations, a significant medium direct correlation between sST2 and NT-proBNP levels was found in Group I and subgroup I А patients. A significant medium correlation and strong inverse correlation between the sST2 and NT-proBNP levels and GFR were found in Group I patients (I А, I B subgroups) and II А subgroup, respectively. However, in Group II and subgroup II B patients, no such correlation was found. In addition, a medium direct correlation between sST2 levels and ischemic cardiomyopathy was found in the smoking subgroups (I А, II А). Our analysis indicates that there is a relationship between the increased risk of development and progression of HF and the progression of renal dysfunction and smoking factors in patients with ACS.
Conclusions. In patients with ACS and GFR <60 ml/min/1.73 m2 (Group I), compared to Group II, as well as in subgroups of smokers (I А, II А), compared to non-smokers (I B, II B), significantly higher mean sST2 and NT-proBNP levels, and significantly higher proportions of patients with sST2 levels ≥35 ng/mL and NTproBNP levels >600 ng/L, were found. Regardless of the smoking factor, a significant strong inverse correlation relationship between sST2 levels and GFR was found in subgroups I А and I B patients. The most marked simultaneous increase in sST2 and NT-proBNP levels was found in smokers with GFR <60 ml/min/1.73m2 (I А), which indicates a significant informational value of these biomarkers in predicting heart failure (HF) in patients with ACS and CKD, taking into account the smoking factor.
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