Meta-Analysis of Soluble Suppression of Tumorigenicity-2 and Prognosis in Acute Heart Failure

Alberto Aimo*, Giuseppe Vergaro, Andrea Ripoli, Antoni Bayes-Genis, Domingo A. Pascual Figal, Rudolf A. de Boer, Johan Lassus, Alexandre Mebazaa, Etienne Gayat, Tobias Breidthardt, Zaid Sabti, Christian Mueller, Hans-Peter Brunner-La Rocca, W. H. Wilson Tang, Justin L. Grodin, Yuhui Zhang, Paulo Bettencourt, Alan S. Maisel, Claudio Passino, James L. JanuzziMichele Emdin

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

81 Citations (Web of Science)


OBJECTIVES The aim of this study was to perform a meta-analysis of currently available data regarding the prognostic significance of soluble suppression of tumorigenecity-2 (sST2) concentration in acute heart failure (AHF).

BACKGROUND Concentration of sST2 may have prognostic value in AHF. A comprehensive assessment of all available studies regarding sST2 in AHF is lacking.

METHODS Three databases (MEDLINE, Cochrane Library, and Scopus) were searched. Inclusion criteria were follow-up studies, papers published in English, enrollment of patients with AHF, and availability of median hazard ratios for all-cause death and other outcome measures, when available.

RESULTS Ten studies were included, with a global population of 4,835 patients and a median follow-up duration of 13.5 months. The following global hazard ratios calculated for log(2)(sST2) were admission sST2 and all-cause death, 2.46 (95% confidence interval [CI]: 1.80 to 3.37; p <0.001); discharge sST2 and all-cause death, 2.06 (95% CI: 1.37 to 3.11; p <0.001); admission sST2 and cardiovascular death, 2.29 (95% CI: 1.41 to 3.73; p <0.001); discharge sST2 and cardiovascular death, 2.20 (95% CI: 1.48 to 3.25; p <0.001); admission sST2 and heart failure (HF) hospitalization, 1.21 (95% CI: 0.96 to 1.52; p = 0.060); discharge sST2 and HF hospitalization, 1.54 (95% CI: 1.03 to 2.32; p = 0.007); admission sST2 and all-cause death or HF hospitalization, 1.74 (95% CI: 1.24 to 2.45; p <0.001); and discharge sST2 and all-cause death or HF hospitalization, 1.63 (95% CI: 1.14 to 2.33; p <0.001).

CONCLUSIONS Plasma sST2 has prognostic value with respect to all-cause and cardiovascular death as well as the composite outcome of all-cause death or HF hospitalization, with both admission and discharge values having prognostic efficacy. Discharge sST2, but not admission sST2, is predictive of HF rehospitalization during follow-up. (C) 2017 by the American College of Cardiology Foundation.

Original languageEnglish
Pages (from-to)287-296
Number of pages10
JournalJACC-Heart Failure
Issue number4
Publication statusPublished - Apr 2017


  • acute heart failure
  • meta-analysis
  • prognosis
  • sST2

Cite this