ST2 is reduced by high-dose omega-3 fatty acid treatment following acute MI and is correlated with reduction of the extracellular volume fraction of non-infarcted myocardium
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KeywordsMyocardial Fibrosis Adverse Cardiac Event Diffuse Myocardial Fibrosis Extracellular Volume Fraction Fatty Acid Treatment
ST2, a member of the interleukin-1 receptor family, has been shown to be independently associated with myocardial strain and adverse cardiac events in patients with both ST-elevation and non-ST elevation myocardial infarction (MI). We sought to determine whether high-dose omega-3 fatty acid therapy (O-3FA) would reduce serum levels of ST2 following acute MI and whether ST2 levels correlated directly with measures of diffuse myocardial fibrosis within non-infarcted myocardium.
We evaluated 358 patients who were enrolled in a randomized, double-blinded, placebo-controlled trial of high-dose O-3FA therapy post acute MI. All patients underwent 3T CMR (Tim Trio/Verio, Siemens, Germany) and evaluation of serum biomarkers at enrollment and after 6-months of randomized study therapy. Patients were followed for adverse cardiac events by study physicians at 6-month intervals thereafter.
Serum ST2 level following acute MI is a strong prognostic marker of post-MI death and congestive heart failure. O-3FA treatment reduced ST2 levels, which were strongly correlated with reduction of the extracellular volume fraction within non-infarcted myocardium. ST2 may serve as a non-invasive serum biomarker of myocardial fibrosis, as well an independent predictor of adverse cardiac events following acute MI.
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