Value of hs‑cTnT, sST2, and Lp‑PLA2 in the classification of acute coronary syndrome

The present study aimed to assess the value of high-sensitivity cardiac troponin T (hs-cTnT), soluble suppression of tumorigenicity 2 protein (sST2) and lipoprotein-associated phospholipase A2 (Lp-PLA2) in the classification of acute coronary syndrome (ACS). A total of 236 patients diagnosed with ACS were enrolled in this retrospective study and were further divided into the non-ST-segment-elevation (NSTE)-ACS group (n=183) and ST-segment elevation myocardial infarction (STEMI) group (n=53). The three biomarkers (hs-cTnT, sST2 and Lp-PLA2) were measured by electrochemiluminescence. The diagnostic performance of each biomarker in differentiating ACS subtypes was evaluated through receiver operating characteristic curve analysis. The DeLong test was applied to compare the discriminatory abilities of the different markers. The binary logistic regression model was employed to analyze the factors influencing ACS classification. The levels of hs-cTnT and sST2 in males were significantly higher in the STEMI group than in the NSTE-ACS group (P<0.05). hs-cTnT [odds ratio (OR)=1.010, 95% CI: 1.007-1.014] and sST2 (OR=1.022, 95% CI: 1.011-1.033) were identified as good predictors for distinguishing STEMI from NSTE-ACS, whereas Lp-PLA2 (P=0.470) was not a suitable biomarker to discriminate between the two types of ACS. Additionally, the diagnostic efficacy of hs-cTnT [area under curve (AUC=0.861)] and the combination of hs-cTnT and sST2 (AUC=0.863) was higher than that of sST2 alone (AUC=0.833, P<0.05). In conclusion, these findings illustrated that hs-cTnT and sST2 are promising biomarkers to classify patients with ACS. Compared with sST2 alone, hs-cTnT and its combined detection demonstrate superior diagnostic efficiency in identifying ACS.