# The value of sST2 in risk stratification and short-term prognosis of acute pulmonary embolism: a pilot study focusing on intermediate-risk subgroups

## TL;DR

This study explores how a biomarker called sST2 can help predict risks and outcomes in patients with intermediate-risk acute pulmonary embolism.

## Contribution

The study introduces sST2 as a novel biomarker for risk stratification and prognosis in intermediate-risk acute pulmonary embolism.

## Key findings

- Higher sST2 levels were found in intermediate-high risk patients compared to intermediate-low risk patients.
- sST2 showed strong predictive power for adverse events with an AUC of 0.832.
- A cut-off value of 16.20 ng/ml for sST2 was identified for predicting risk stratification and adverse events.

## Abstract

Intermediate-risk acute pulmonary embolism (APE) represents a heterogeneous group that is temporarily hemodynamically stable and still has a high mortality. The aim of this study was to assess the predictive value of soluble growth stimulation expressed gene 2 (sST2) in risk stratification and short-term prognosis in this group.

This retrospective observational study included 128 patients with intermediate-risk APE between February 2020 to November 2023. Univariate or multivariate analysis were carried out for exploring the associations of sST2 with risk stratification and adverse event. Univariate logistic regression analysis and characteristic curve (ROC) were performed.

Compared with the intermediate-low risk group, higher sST2 level (25.8 ng/ml vs. 11.5 ng/ml, P < 0.001) and more adverse events (28.2% vs. 8%, P = 0.006) were observed in the intermediate-high risk group. Univariate logistic regression analysis showed that sST2 was associated with higher risk stratification (OR = 1.085, 95%CI 1.042–1.129, P < 0.001) and adverse events (OR = 1.049, 95%CI 1.027–1.072, P < 0.001). For intermediate-high risk stratification prediction, the AUC (area under the curve) was 0.754 (95% CI: 0.671–0.837, P < 0.001) using sST2 and the optimal probability of cut-off value was 16.20 ng/ml. For adverse events prediction, the AUC was 0.832 (95% CI 0.751–0.913; P < 0.001), while the optimal cut-off value was 16.20 ng/ml.

sST2 is associated with risk stratification and poor short-term prognosis for intermediate-risk APE, and it is a promising new biomarker that may contribute to further stratification for intermediate-risk subgroups and identification of individuals with a propensity to develop adverse events during hospitalization.