NSTEMI Risk Prediction with the Combination of the Biomarkers Epicardial Adipose Tissue and Soluble Suppression of Tumorigenicity 2

BACKGROUND Epicardial adipose tissue (EAT) and soluble suppression of tumorigenicity 2 (sST2) are valuable markers of myocardial fibrosis, but the relationship between EAT and sST2 remains controversial. This study aimed to evaluate the role of combined EAT measurements and levels of sST2 and the risk of major adverse cardiovascular events (MACEs) in patients with diagnosis of non-ST-elevation myocardial infarction (NSTEMI). MATERIAL AND METHODS This was a single-center retrospective observational study. Patients diagnosed with NSTEMI from December 2019 to December 2022 were included. All patients completed the sST2 tests and computed tomography angiography during hospitalization. During the 12-month follow-up, MACEs were defined as all-cause death, reinfarction, and new congestive heart failure. RESULTS A total of 435 patients were enrolled in this study, of whom 59 patients (13.6%) developed MACEs. After adjusting for confounding factors, multivariate COX regression analysis showed that high EAT index (EATi) (HR=4.60; 95% CI 2.499-8.481; P<0.001) and high sST2 (HR=3.35; 95% CI 1.894-5.914; P<0.001) were the independent predictors of MACEs. According to Pearson correlation analysis, there was a positive correlation between EATi and sST2 (r=0.347, P<0.001). Kaplan-Meier analysis showed the patients with high sST2 or EATi had a significantly higher long-term risk of MACEs (both, log-rank P<0.001). After the addition of EATi and/or sST2, the predictive ability of the new model for MACEs was significantly improved (P<0.005). CONCLUSIONS EAT and sST2 are positively correlated in patients with NSTEMI. The combination of EAT and sST2 has a solid potential for predicting MACEs in patients with NSTEMI.