Soluble ST2 (sST2) is a promising biomarker in inflammation, atherosclerosis, and cardiovascular diseases. We investigated the association between serum sST2 and poor outcome in patients with transient ischaemic attack (TIA)/ischaemic stroke.
Patients within 24 h after onset and with measured serum sST2 were prospectively enrolled in this study. Poor outcome was a combination of a new stroke event (ischaemic or haemorrhagic) and all-cause death within 90 days and 1 year. The associations of serum sST2 with poor outcome were analysed by Cox proportional hazards.
Among 430 patients included, the median (interquartile range) of sST2 was 17.72 (9.31-28.84) ng/mL. 19 (4.4%) and 38 (8.8%) patients experienced poor outcome within 90 days and 1 year, respectively. Compared with the lowest sST2 tertile, hazard ratios (95% confidence intervals) for the highest tertile were 5.14 (1.43-18.51) for poor outcome within 90 days and 3.00 (1.29-6.97) at 1 year after multivariate adjustments. Adding sST2 to a prediction model significantly improved risk stratification of poor outcome in TIA/ischaemic stroke, as observed by the continuous net reclassification improvement (NRI) of 60.98% (95% CI: 15.37%-106.6%, P=0.009) and integrated discrimination improvement (IDI) of 2.63% (95% CI: 0.08%-5.18%, P=0.043) at 90 days, and the continuous NRI of 41.68% (95% CI: 8.74%-74.61%, P=0.013) at 1 year.
Increased serum sST2 levels in TIA/ischaemic stroke were associated with increased risks of poor outcome within 90 days and 1 year, suggesting that serum sST2 may be a potential long-term prognostic biomarker for TIA/ischaemic stroke.

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