ST2
IL1RL1proteinST2 signals myocardial stress and remodeling response post-infarction, serving as an off-pathway hemodynamic/mechanical stress indicator.
Pathway placement
Cascade stepOff-pathway / systemic markers
Confidencehigh
RationaleCardiac remodeling, mechanical stress, and neurohormonal/hemodynamic response marker.
Druggability
DruggableYes
Known drugs / candidates1
Small-molecule tractableNo
Antibody tractableYes
EnsemblENSG00000115602
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I67
C — confounder / Type-II56
A — assay feasibility84
E — evidence strength66
T1DI (composite)31
Specificity differential (R−C)+11.1
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationn/a
2anemia / acute blood lossmag 2
3hypovolemia / dehydrationn/a
4tachyarrhythmiamag 2
5hypoxemia / respiratory failuren/a
6hypertensive emergencymag 1
7high-demand / peri-operative stressn/a
Coverage: 3/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 8 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · K2/K3-EDTA (lavender-top)
Method / principle
Sandwich immunoassay (Presage ST2 ELISA)
Reagent / substrate
Anti-ST2 antibody pair
Platform
ELISA / automated
Turnaround · availability
Send-out · FDA-cleared (Presage ST2)
Literature evidence(21)
- Silent Myocardial Infarction Revisited: Immuno-metabolic Mechanisms, Multimodal Biomarkers, and Translational Diagnostics.Journal of cardiovascular translational research · 2026 · PMID 41784746 · doi
- Comprehensive Quality Analysis of Conventional and Novel Biomarkers in Diagnosing and Predicting Prognosis of Coronary Artery Disease, Acute Coronary Syndrome, and Heart Failure, a Comprehensive Literature Review.Journal of cardiovascular translational research · 2024 · PMID 38995611 · doi
- Colchicine effect on biomarkers of cardiac remodelling and atherosclerosis in ST-elevation myocardial infarction: A randomized controlled trial.British journal of clinical pharmacology · 2024 · PMID 39359014 · doi
- Novel predictive role for mid-regional proadrenomedullin in moderate to severe aortic stenosis.Heart (British Cardiac Society) · 2022 · PMID 35332049 · doi
- Cardiac Biomarkers and Risk of Atherosclerotic Cardiovascular Disease in Patients with CKD.Kidney360 · 2022 · PMID 36128494 · doi
- Current Use of Cardiac Biomarkers in Various Heart Conditions.Endocrine, metabolic & immune disorders drug targets · 2021 · PMID 32867665 · doi
- A Review of Novel Cardiac Biomarkers in Acute or Chronic Cardiovascular Diseases: The Role of Soluble ST2 (sST2), Lipoprotein-Associated Phospholipase A2 (Lp-PLA2), Myeloperoxidase (MPO), and Procalcitonin (PCT).Disease markers · 2021 · PMID 34422136 · doi
- Factors which Influence the Levels of ST-2, Galectin-3 and MMP-9 in Acute Coronary Syndrome.Cardiovascular & hematological disorders drug targets · 2020 · PMID 31438834 · doi
- Adverse Cardiac Remodelling after Acute Myocardial Infarction: Old and New Biomarkers.Disease markers · 2020 · PMID 32626540 · doi
- Using proximity extension proteomics assay to identify biomarkers associated with infarct size and ejection fraction after ST-elevation myocardial infarction.Scientific reports · 2020 · PMID 33122738 · doi
- NLRP3 Inflammasome Biomarker-Could Be the New Tool for Improved Cardiometabolic Syndrome Outcome.Metabolites · 2020 · PMID 33172097 · doi
- Novel biomarkers of cardiovascular disease: Applications in clinical practice.Critical reviews in clinical laboratory sciences · 2018 · PMID 30457415 · doi
- Magnitude of Soluble ST2 as a Novel Biomarker for Acute Aortic Dissection.Circulation · 2017 · PMID 29146682 · doi
- Beyond Cholesterol - New Cardiovascular Biomarkers.Nestle Nutrition Institute workshop series · 2016 · PMID 26764476 · doi
- Relation of baseline plasma MMP-1 levels to long-term all-cause mortality in patients with known or suspected coronary artery disease referred for coronary angiography.Atherosclerosis · 2015 · PMID 25635325 · doi
- Cardiovascular biomarkers and sex: the case for women.Nature reviews. Cardiology · 2015 · PMID 26149486 · doi
- Overview of cardiac markers in heart disease.Clinics in laboratory medicine · 2014 · PMID 24507783 · doi
- Emerging biomarkers for acute heart conditions.Current opinion in cardiology · 2014 · PMID 24806784 · doi
- ST2: a novel remodeling biomarker in acute and chronic heart failure.Current heart failure reports · 2010 · PMID 20425491 · doi
- Biomarkers in acute myocardial infarction.BMC medicine · 2010 · PMID 20529285 · doi
- IL-33 reduces the development of atherosclerosis.The Journal of experimental medicine · 2008 · PMID 18268038 · doi