TY - JOUR
T1 - sST2 Predicts Outcome in Chronic Heart Failure Beyond N-proBNP and High-Sensitivity Troponin T
AU - Emdin, Michele
AU - Aimo, Alberto
AU - Vergaro, Giuseppe
AU - Bayes-Genis, Antoni
AU - Lupon, Josep
AU - Latini, Roberto
AU - Meessen, Jennifer
AU - Anand, Inder S.
AU - Cohn, Jay N.
AU - Gravning, Jorgen
AU - Gullestad, Lars
AU - Broch, Kaspar
AU - Ueland, Thor
AU - Nymo, Stale H.
AU - Rocca, Hans-Peter Brunner-La
AU - de Boer, Rudolf A.
AU - Gaggin, Hanna K.
AU - Ripoli, Andrea
AU - Passino, Claudio
AU - Januzzi, James L.
PY - 2018/11/6
Y1 - 2018/11/6
N2 - BACKGROUND Soluble suppression of tumorigenesis-2 (sST2) is a biomarker related to inflammation and fibrosis. OBJECTIVES This study assessed the independent prognostic value of sST2 in chronic heart failure (HF). METHODS Individual patient data from studies that assessed sST2 for risk prediction in chronic HF, together with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT), were retrieved. RESULTS A total of 4,268 patients were evaluated (median age 68 years, 75% males, 65% with ischemic HF, 87% with left ventricular ejection fraction [LVEF] <40%). NT-proBNP, hs-TnT, and sST2 were 1,360 ng/l (interquartile interval: 513 to 3,222 ng/l), 18 ng/l (interquartile interval: 9 to 33 ng/l), and 27 ng/l (interquartile interval: 20 to 39 ng/l), respectively. During a 2.4-year median follow-up, 1,319 patients (31%) experienced all-cause death (n = 932 [22%] for cardiovascular causes). Among the 4,118 patients (96%) with available data, 1,029 (24%) were hospitalized at least once for worsening HF over 2.2 years. The best sST2 cutoff for the prediction of all-cause and cardiovascular death and HF hospitalization was 28 ng/ml, with good performance at Kaplan-Meier analysis (log-rank: 117.6, 61.0, and 88.6, respectively; all p < 0.001). In a model that included age, sex, body mass index, ischemic etiology, LVEF, New York Heart Association functional class, glomerular filtration rate, HF medical therapy, NT-proBNP, and hs-TnT, the risk of all-cause death, cardiovascular death, and HF hospitalization increased by 26%, 25%, and 30%, respectively, per each doubling of sST2. sST2 retained its independent prognostic value across most population subgroups. CONCLUSIONS sST2 yielded strong, independent predictive value for all-cause and cardiovascular mortality, and HF hospitalization in chronic HF, and deserves consideration to be part of a multimarker panel together with NT-proBNP and hs-TnT. (c) 2018 by the American College of Cardiology Foundation.
AB - BACKGROUND Soluble suppression of tumorigenesis-2 (sST2) is a biomarker related to inflammation and fibrosis. OBJECTIVES This study assessed the independent prognostic value of sST2 in chronic heart failure (HF). METHODS Individual patient data from studies that assessed sST2 for risk prediction in chronic HF, together with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT), were retrieved. RESULTS A total of 4,268 patients were evaluated (median age 68 years, 75% males, 65% with ischemic HF, 87% with left ventricular ejection fraction [LVEF] <40%). NT-proBNP, hs-TnT, and sST2 were 1,360 ng/l (interquartile interval: 513 to 3,222 ng/l), 18 ng/l (interquartile interval: 9 to 33 ng/l), and 27 ng/l (interquartile interval: 20 to 39 ng/l), respectively. During a 2.4-year median follow-up, 1,319 patients (31%) experienced all-cause death (n = 932 [22%] for cardiovascular causes). Among the 4,118 patients (96%) with available data, 1,029 (24%) were hospitalized at least once for worsening HF over 2.2 years. The best sST2 cutoff for the prediction of all-cause and cardiovascular death and HF hospitalization was 28 ng/ml, with good performance at Kaplan-Meier analysis (log-rank: 117.6, 61.0, and 88.6, respectively; all p < 0.001). In a model that included age, sex, body mass index, ischemic etiology, LVEF, New York Heart Association functional class, glomerular filtration rate, HF medical therapy, NT-proBNP, and hs-TnT, the risk of all-cause death, cardiovascular death, and HF hospitalization increased by 26%, 25%, and 30%, respectively, per each doubling of sST2. sST2 retained its independent prognostic value across most population subgroups. CONCLUSIONS sST2 yielded strong, independent predictive value for all-cause and cardiovascular mortality, and HF hospitalization in chronic HF, and deserves consideration to be part of a multimarker panel together with NT-proBNP and hs-TnT. (c) 2018 by the American College of Cardiology Foundation.
KW - heart failure
KW - NT-proBNP
KW - prognosis
KW - sST2
KW - troponin T
KW - REDUCED EJECTION FRACTION
KW - SOLUBLE ST2
KW - PROGNOSTIC VALUE
KW - NATRIURETIC PEPTIDES
KW - AMBULATORY PATIENTS
KW - TASK-FORCE
KW - THERAPY
KW - BIOMARKERS
KW - ASSOCIATION
KW - EPIDEMIOLOGY
U2 - 10.1016/j.jacc.2018.08.2165
DO - 10.1016/j.jacc.2018.08.2165
M3 - Article
SN - 0735-1097
VL - 72
SP - 2309
EP - 2320
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 19
ER -