Abstract: 【Abstract】Objective To investigate the relationship between the serum levels of soluble growth stimulation expressed gene 2 (ST2) and tenascin-C (TN-C) and the cardiovascular events in maintenance hemodialysis (MHD) patients. Method This study enrolled 115 MHD patients admitted to the First Affiliated Hospital of Xinxiang Medical College from October 2016 to October 2019. According to the presence or absence of cardiovascular events, they were divided into two groups: cardiovascular event group (n=47) and non-cardiovascular event group (n=68). In addition, 58 healthy volunteers in the First Affiliated Hospital of Xinxiang Medical College were recruited as the control group. Clinical data of the patients were collected. Serum ST2 and TN-C levels of the patients and healthy controls were assayed by ELISA. Multivariate logistic regression was used to analyze the influencing factors for cardiovascular events in MHD patients. ROC curve was used to evaluate the predictive value of every index for cardiovascular events in MHD patients. Results Serum ST2 and TN-C levels were significantly higher in MHD group than in control group (t=30.357 and 42.237 respectively,P<0.001). Gender, primary disease, systolic blood pressure, total cholesterol, high-density lipoproteins, low-density lipoproteins, triacylglycerol, blood phosphorus, blood calcium, serum creatinine, left ventricular ejection fraction and left ventricular end diastolic diameter had no statistical significances between cardiovascular
event group and non-cardiovascular event group (χ2=0.096，P=0.757; χ2=0.961, P=0.327; t=1.456，P=0.074; t=0.850, P=0.199; t=0.566, P=0.286; t=0.744, P=0.229; t=1.494, P=0.069; t=1.245, P=0.108; t=0.798, P=0.213; t=1.641, P= 0.052; t=0.695, P=0.244), but age (χ2=4.865, P=0.027), dialysis time(t=15.078,P＜0.001), C-reaction protein (t=9.285, P＜0.001), uric acid (t=17.549, P＜0.001), albumin (t=4.213, P＜0.001), ST2 (t=18.337, P＜0.001) and TN-C (t=16.585, P＜0.001) were significantly higher in cardiovascular event group than in non- cardiovascular event group. Multivariate logistic regression analysis showed that age (OR=2.235, 95% CI: 1.215～4.102, P=0.015), dialysis time (OR=4.251, 95% CI: 1.025～4.305, P=0.038), ST2 (OR=6.560, 95% CI: 1.059～2.300, P=0.024) and TN-C (OR=5.208, 95% CI: 1.043～1.397, P=0.013)
were the independent risk factors for cardiovascular events in MHD patients. ROC curve showed that the AUC for predicting cardiovascular events using ST2 and TN-C levels were 0.813 and 0.786 respectively, the sensitivities were 78.62% and 76.30% respectively, and the specificities were 73.41% and 70.72% respectively. Conclusion Serum ST2 and TN-C levels increased significantly in MHD patients. Higher serum ST2 and TN-C levels were the influencing factors for cardiovascular events in MHD patients, and also had predictive value for cardiovascular events in MHD patients.

Key words: Maintenance hemodialysis, Soluble growth stimulation expressed gene 2 (ST2), Tenascin-C (TN-C), Cardiovascular event