Circulating levels and prognostic cut-offs of sST2, hs-cTnT, and NT-proBNP in women vs. men with chronic heart failure

Giuseppe Vergaro; Francesco Gentile; Alberto Aimo; James L Januzzi; A Mark Richards; Carolyn S P Lam; Rudolf A de Boer; Laura M G Meems; Roberto Latini; Lidia Staszewsky; Inder S Anand; Jay N Cohn; Thor Ueland; Lars Gullestad; Pål Aukrust; Hans-Peter Brunner-La Rocca; Antoni Bayes-Genis; Josep Lupón; Akiomi Yoshihisa; Yasuchika Takeishi; Michael Egstrup; Ida Gustafsson; Hanna K Gaggin; Kai M Eggers; Kurt Huber; Greg D Gamble; Lieng H Ling; Kui Toh Gerard Leong; Poh Shuah Daniel Yeo; Hean Yee Ong; Fazlur Jaufeerally; Tze P Ng; Richard Troughton; Robert N Doughty; Gerry Devlin; Mayanna Lund; Alberto Giannoni; Claudio Passino; Michele Emdin

doi:10.1002/ehf2.13883

Circulating levels and prognostic cut-offs of sST2, hs-cTnT, and NT-proBNP in women vs. men with chronic heart failure

Giuseppe Vergaro^*, Francesco Gentile, Alberto Aimo, James L Januzzi, A Mark Richards, Carolyn S P Lam, Rudolf A de Boer, Laura M G Meems, Roberto Latini, Lidia Staszewsky, Inder S Anand, Jay N Cohn, Thor Ueland, Lars Gullestad, Pål Aukrust, Hans-Peter Brunner-La Rocca, Antoni Bayes-Genis, Josep Lupón, Akiomi Yoshihisa, Yasuchika TakeishiMichael Egstrup, Ida Gustafsson, Hanna K Gaggin, Kai M Eggers, Kurt Huber, Greg D Gamble, Lieng H Ling, Kui Toh Gerard Leong, Poh Shuah Daniel Yeo, Hean Yee Ong, Fazlur Jaufeerally, Tze P Ng, Richard Troughton, Robert N Doughty, Gerry Devlin, Mayanna Lund, Alberto Giannoni, Claudio Passino, Michele Emdin

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

AIMS: To define plasma concentrations, determinants, and optimal prognostic cut-offs of soluble suppression of tumorigenesis-2 (sST2), high-sensitivity cardiac troponin T (hs-cTnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in women and men with chronic heart failure (HF).

METHODS AND RESULTS: Individual data of patients from the Biomarkers In Heart Failure Outpatient Study (BIOS) Consortium with sST2, hs-cTnT, and NT-proBNP measured were analysed. The primary endpoint was a composite of 1 year cardiovascular death and HF hospitalization. The secondary endpoints were 5 year cardiovascular and all-cause death. The cohort included 4540 patients (age 67 ± 12 years, left ventricular ejection fraction 33 ± 13%, 1111 women, 25%). Women showed lower sST2 (24 vs. 27 ng/mL, P < 0.001) and hs-cTnT level (15 vs. 20 ng/L, P < 0.001), and similar concentrations of NT-proBNP (1540 vs. 1505 ng/L, P = 0.408). Although the three biomarkers were confirmed as independent predictors of outcome in both sexes, the optimal prognostic cut-off was lower in women for sST2 (28 vs. 31 ng/mL) and hs-cTnT (22 vs. 25 ng/L), while NT-proBNP cut-off was higher in women (2339 ng/L vs. 2145 ng/L). The use of sex-specific cut-offs improved risk prediction compared with the use of previously standardized prognostic cut-offs and allowed to reclassify the risk of many patients, to a greater extent in women than men, and for hs-cTnT than sST2 or NT-proBNP. Specifically, up to 18% men and up to 57% women were reclassified, by using the sex-specific cut-off of hs-cTnT for the endpoint of 5 year cardiovascular death.

CONCLUSIONS: In patients with chronic HF, concentrations of sST2 and hs-cTnT, but not of NT-proBNP, are lower in women. Lower sST2 and hs-cTnT and higher NT-proBNP cut-offs for risk stratification could be used in women.

Original language	English
Pages (from-to)	2084-2095
Number of pages	12
Journal	Esc heart failure
Volume	9
Issue number	4
Early online date	5 May 2022
DOIs	https://doi.org/10.1002/ehf2.13883
Publication status	Published - Aug 2022

Keywords

CARDIAC TROPONIN ASSAYS
Chronic heart failure
ELDERLY-PATIENTS
EUROPEAN-SOCIETY
High-sensitivity troponin T
IMPACT
NATRIURETIC PEPTIDES
NT-proBNP
Prognosis
REDUCED EJECTION FRACTION
SEX
SOLUBLE ST2
Sex
TESTOSTERONE
TUMORIGENICITY-2
Women
sST2

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Vergaro, G., Gentile, F., Aimo, A., Januzzi, J. L., Richards, A. M., Lam, C. S. P., de Boer, R. A., Meems, L. M. G., Latini, R., Staszewsky, L., Anand, I. S., Cohn, J. N., Ueland, T., Gullestad, L., Aukrust, P., Brunner-La Rocca, H.-P., Bayes-Genis, A., Lupón, J., Yoshihisa, A., ... Emdin, M. (2022). Circulating levels and prognostic cut-offs of sST2, hs-cTnT, and NT-proBNP in women vs. men with chronic heart failure. Esc heart failure, 9(4), 2084-2095. https://doi.org/10.1002/ehf2.13883

@article{b9f14789538c43b1847dc9f990d826ac,

title = "Circulating levels and prognostic cut-offs of sST2, hs-cTnT, and NT-proBNP in women vs. men with chronic heart failure",

abstract = "AIMS: To define plasma concentrations, determinants, and optimal prognostic cut-offs of soluble suppression of tumorigenesis-2 (sST2), high-sensitivity cardiac troponin T (hs-cTnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in women and men with chronic heart failure (HF).METHODS AND RESULTS: Individual data of patients from the Biomarkers In Heart Failure Outpatient Study (BIOS) Consortium with sST2, hs-cTnT, and NT-proBNP measured were analysed. The primary endpoint was a composite of 1 year cardiovascular death and HF hospitalization. The secondary endpoints were 5 year cardiovascular and all-cause death. The cohort included 4540 patients (age 67 ± 12 years, left ventricular ejection fraction 33 ± 13%, 1111 women, 25%). Women showed lower sST2 (24 vs. 27 ng/mL, P < 0.001) and hs-cTnT level (15 vs. 20 ng/L, P < 0.001), and similar concentrations of NT-proBNP (1540 vs. 1505 ng/L, P = 0.408). Although the three biomarkers were confirmed as independent predictors of outcome in both sexes, the optimal prognostic cut-off was lower in women for sST2 (28 vs. 31 ng/mL) and hs-cTnT (22 vs. 25 ng/L), while NT-proBNP cut-off was higher in women (2339 ng/L vs. 2145 ng/L). The use of sex-specific cut-offs improved risk prediction compared with the use of previously standardized prognostic cut-offs and allowed to reclassify the risk of many patients, to a greater extent in women than men, and for hs-cTnT than sST2 or NT-proBNP. Specifically, up to 18% men and up to 57% women were reclassified, by using the sex-specific cut-off of hs-cTnT for the endpoint of 5 year cardiovascular death.CONCLUSIONS: In patients with chronic HF, concentrations of sST2 and hs-cTnT, but not of NT-proBNP, are lower in women. Lower sST2 and hs-cTnT and higher NT-proBNP cut-offs for risk stratification could be used in women.",

keywords = "CARDIAC TROPONIN ASSAYS, Chronic heart failure, ELDERLY-PATIENTS, EUROPEAN-SOCIETY, High-sensitivity troponin T, IMPACT, NATRIURETIC PEPTIDES, NT-proBNP, Prognosis, REDUCED EJECTION FRACTION, SEX, SOLUBLE ST2, Sex, TESTOSTERONE, TUMORIGENICITY-2, Women, sST2",

author = "Giuseppe Vergaro and Francesco Gentile and Alberto Aimo and Januzzi, {James L} and Richards, {A Mark} and Lam, {Carolyn S P} and {de Boer}, {Rudolf A} and Meems, {Laura M G} and Roberto Latini and Lidia Staszewsky and Anand, {Inder S} and Cohn, {Jay N} and Thor Ueland and Lars Gullestad and P{\aa}l Aukrust and {Brunner-La Rocca}, Hans-Peter and Antoni Bayes-Genis and Josep Lup{\'o}n and Akiomi Yoshihisa and Yasuchika Takeishi and Michael Egstrup and Ida Gustafsson and Gaggin, {Hanna K} and Eggers, {Kai M} and Kurt Huber and Gamble, {Greg D} and Ling, {Lieng H} and Leong, {Kui Toh Gerard} and Yeo, {Poh Shuah Daniel} and Ong, {Hean Yee} and Fazlur Jaufeerally and Ng, {Tze P} and Richard Troughton and Doughty, {Robert N} and Gerry Devlin and Mayanna Lund and Alberto Giannoni and Claudio Passino and Michele Emdin",

note = "{\textcopyright} 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.",

year = "2022",

month = aug,

doi = "10.1002/ehf2.13883",

language = "English",

volume = "9",

pages = "2084--2095",

journal = "Esc heart failure",

issn = "2055-5822",

publisher = "John Wiley & Sons Inc.",

number = "4",

}

Vergaro, G, Gentile, F, Aimo, A, Januzzi, JL, Richards, AM, Lam, CSP, de Boer, RA, Meems, LMG, Latini, R, Staszewsky, L, Anand, IS, Cohn, JN, Ueland, T, Gullestad, L, Aukrust, P, Brunner-La Rocca, H-P, Bayes-Genis, A, Lupón, J, Yoshihisa, A, Takeishi, Y, Egstrup, M, Gustafsson, I, Gaggin, HK, Eggers, KM, Huber, K, Gamble, GD, Ling, LH, Leong, KTG, Yeo, PSD, Ong, HY, Jaufeerally, F, Ng, TP, Troughton, R, Doughty, RN, Devlin, G, Lund, M, Giannoni, A, Passino, C & Emdin, M 2022, 'Circulating levels and prognostic cut-offs of sST2, hs-cTnT, and NT-proBNP in women vs. men with chronic heart failure', Esc heart failure, vol. 9, no. 4, pp. 2084-2095. https://doi.org/10.1002/ehf2.13883

TY - JOUR

T1 - Circulating levels and prognostic cut-offs of sST2, hs-cTnT, and NT-proBNP in women vs. men with chronic heart failure

AU - Vergaro, Giuseppe

AU - Gentile, Francesco

AU - Aimo, Alberto

AU - Januzzi, James L

AU - Richards, A Mark

AU - Lam, Carolyn S P

AU - de Boer, Rudolf A

AU - Meems, Laura M G

AU - Latini, Roberto

AU - Staszewsky, Lidia

AU - Anand, Inder S

AU - Cohn, Jay N

AU - Ueland, Thor

AU - Gullestad, Lars

AU - Aukrust, Pål

AU - Brunner-La Rocca, Hans-Peter

AU - Bayes-Genis, Antoni

AU - Lupón, Josep

AU - Yoshihisa, Akiomi

AU - Takeishi, Yasuchika

AU - Egstrup, Michael

AU - Gustafsson, Ida

AU - Gaggin, Hanna K

AU - Eggers, Kai M

AU - Huber, Kurt

AU - Gamble, Greg D

AU - Ling, Lieng H

AU - Leong, Kui Toh Gerard

AU - Yeo, Poh Shuah Daniel

AU - Ong, Hean Yee

AU - Jaufeerally, Fazlur

AU - Ng, Tze P

AU - Troughton, Richard

AU - Doughty, Robert N

AU - Devlin, Gerry

AU - Lund, Mayanna

AU - Giannoni, Alberto

AU - Passino, Claudio

AU - Emdin, Michele

PY - 2022/8

Y1 - 2022/8

N2 - AIMS: To define plasma concentrations, determinants, and optimal prognostic cut-offs of soluble suppression of tumorigenesis-2 (sST2), high-sensitivity cardiac troponin T (hs-cTnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in women and men with chronic heart failure (HF).METHODS AND RESULTS: Individual data of patients from the Biomarkers In Heart Failure Outpatient Study (BIOS) Consortium with sST2, hs-cTnT, and NT-proBNP measured were analysed. The primary endpoint was a composite of 1 year cardiovascular death and HF hospitalization. The secondary endpoints were 5 year cardiovascular and all-cause death. The cohort included 4540 patients (age 67 ± 12 years, left ventricular ejection fraction 33 ± 13%, 1111 women, 25%). Women showed lower sST2 (24 vs. 27 ng/mL, P < 0.001) and hs-cTnT level (15 vs. 20 ng/L, P < 0.001), and similar concentrations of NT-proBNP (1540 vs. 1505 ng/L, P = 0.408). Although the three biomarkers were confirmed as independent predictors of outcome in both sexes, the optimal prognostic cut-off was lower in women for sST2 (28 vs. 31 ng/mL) and hs-cTnT (22 vs. 25 ng/L), while NT-proBNP cut-off was higher in women (2339 ng/L vs. 2145 ng/L). The use of sex-specific cut-offs improved risk prediction compared with the use of previously standardized prognostic cut-offs and allowed to reclassify the risk of many patients, to a greater extent in women than men, and for hs-cTnT than sST2 or NT-proBNP. Specifically, up to 18% men and up to 57% women were reclassified, by using the sex-specific cut-off of hs-cTnT for the endpoint of 5 year cardiovascular death.CONCLUSIONS: In patients with chronic HF, concentrations of sST2 and hs-cTnT, but not of NT-proBNP, are lower in women. Lower sST2 and hs-cTnT and higher NT-proBNP cut-offs for risk stratification could be used in women.

AB - AIMS: To define plasma concentrations, determinants, and optimal prognostic cut-offs of soluble suppression of tumorigenesis-2 (sST2), high-sensitivity cardiac troponin T (hs-cTnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in women and men with chronic heart failure (HF).METHODS AND RESULTS: Individual data of patients from the Biomarkers In Heart Failure Outpatient Study (BIOS) Consortium with sST2, hs-cTnT, and NT-proBNP measured were analysed. The primary endpoint was a composite of 1 year cardiovascular death and HF hospitalization. The secondary endpoints were 5 year cardiovascular and all-cause death. The cohort included 4540 patients (age 67 ± 12 years, left ventricular ejection fraction 33 ± 13%, 1111 women, 25%). Women showed lower sST2 (24 vs. 27 ng/mL, P < 0.001) and hs-cTnT level (15 vs. 20 ng/L, P < 0.001), and similar concentrations of NT-proBNP (1540 vs. 1505 ng/L, P = 0.408). Although the three biomarkers were confirmed as independent predictors of outcome in both sexes, the optimal prognostic cut-off was lower in women for sST2 (28 vs. 31 ng/mL) and hs-cTnT (22 vs. 25 ng/L), while NT-proBNP cut-off was higher in women (2339 ng/L vs. 2145 ng/L). The use of sex-specific cut-offs improved risk prediction compared with the use of previously standardized prognostic cut-offs and allowed to reclassify the risk of many patients, to a greater extent in women than men, and for hs-cTnT than sST2 or NT-proBNP. Specifically, up to 18% men and up to 57% women were reclassified, by using the sex-specific cut-off of hs-cTnT for the endpoint of 5 year cardiovascular death.CONCLUSIONS: In patients with chronic HF, concentrations of sST2 and hs-cTnT, but not of NT-proBNP, are lower in women. Lower sST2 and hs-cTnT and higher NT-proBNP cut-offs for risk stratification could be used in women.

KW - CARDIAC TROPONIN ASSAYS

KW - Chronic heart failure

KW - ELDERLY-PATIENTS

KW - EUROPEAN-SOCIETY

KW - High-sensitivity troponin T

KW - IMPACT

KW - NATRIURETIC PEPTIDES

KW - NT-proBNP

KW - Prognosis

KW - REDUCED EJECTION FRACTION

KW - SEX

KW - SOLUBLE ST2

KW - Sex

KW - TESTOSTERONE

KW - TUMORIGENICITY-2

KW - Women

KW - sST2

U2 - 10.1002/ehf2.13883

DO - 10.1002/ehf2.13883

M3 - Article

C2 - 35510529

SN - 2055-5822

VL - 9

SP - 2084

EP - 2095

JO - Esc heart failure

JF - Esc heart failure

IS - 4

ER -

Circulating levels and prognostic cut-offs of sST2, hs-cTnT, and NT-proBNP in women vs. men with chronic heart failure

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Keywords

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