Prospective diagnostic accuracy study of plasma soluble ST2 for diagnosis of acute aortic syndromes

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 o...

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Bibliographic Details
Published in:Scientific reports 2020-02, Vol.10 (1), p.3103, Article 3103
Main Authors: Morello, Fulvio, Bartalucci, Alice, Bironzo, Marco, Santoro, Marco, Pivetta, Emanuele, Ianniello, Alice, Rumbolo, Francesca, Mengozzi, Giulio, Lupia, Enrico
Format: Article
Language:English
Subjects:
Accuracy
Aged
Aged, 80 and over
Aneurysm, Dissecting - blood
Aneurysm, Dissecting - diagnosis
Angiography
Aorta
Aortic Aneurysm - blood
Aortic Aneurysm - diagnosis
Area Under Curve
Biomarkers
Biomarkers - blood
Cardiology - standards
Computed tomography
Congestive heart failure
Diagnosis
Emergency medical care
Female
Fibrin Fibrinogen Degradation Products - analysis
Humans
Interleukin-1 Receptor-Like 1 Protein - blood
Male
Middle Aged
Perfusion
Prognosis
Prospective Studies
Reproducibility of Results
Risk Factors
ROC Curve
Syncope
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Summary: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 
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-020-59884-6