• Jaewon Oh, Sungha Park, Hee Tae Yu, Hyuk Jae Chang, Sang Hak Lee, Seok Min Kang, and Donghoon Choi.
• Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
• Yonsei Med. J. 2016 Nov 1; 57 (6): 134713531347-53.

PurposeSoluble ST2 (sST2) is an emerging prognostic biomarker in patients with cardiovascular disease (CVD). A recent study showed that sST2 predicted incident hypertension. High sensitive C-reactive protein (hsCRP) has been a widely-used biomarker for risk-stratifying in CVD. We compared the abilities of sST2 and hsCRP to predict high risk coronary artery calcium score (CACS).Materials And MethodsThe CACS was assessed by cardiac computed tomography, and sST2 was measured in 456 subjects enrolled in the Mapo-gu community cohort. In accordance with the 2013 ACC/AHA guidelines, we defined the high risk CACS group as individuals with a CACS ≥300 Agatston units (AU).ResultsThere were 99 (21.7%) subjects with a CACS ≥300 AU. There was a strong correlation between log sST2 and log hsCRP (r=0.128, p=0.006), and both log sST2 and log hsCRP showed significant associations with CACS (r=0.101, p=0.031 for sST2, r=0.101, p=0.032 for hsCRP). In net reclassification improvement (NRI) analysis, the NRI for hsCRP over sST2 was significant [continuous NRI 0.238, 95% confidence interval (CI) 0.001-0.474, integrated discrimination index (IDI) 0.022, p=0.035], while the NRI for sST2 over hsCRP was not significant (continuous NRI 0.212, 95% CI -0.255-0.453, IDI 0.002, p=0.269).ConclusionsST2 does not improve net reclassification for predicting a high risk CACS. Using hsCRP provides superior discrimination and risk reclassification for coronary atherosclerosis, compared with sST2.

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