Serial monitoring of soluble interleukin family member ST2 in patients with acutely decompensated heart failure.

Published

Journal Article

OBJECTIVES: To determine whether serial measures of the interleukin receptor family member soluble ST2 (sST2) provide additional prognostic information to baseline measures for long-term risk stratification of acutely decompensated heart failure (ADHF) patients. METHODS: We prospectively enrolled 72 ADHF patients. Blood samples were collected to measure sST2 concentrations at presentation and on day 4 of hospitalization. All patients were clinically followed, and vital status was registered. RESULTS: Between presentation and day 4, sST2 concentrations decreased from 62 ng/ml (interquartile range 38-105) to 44 ng/ml (interquartile range 26-72; p < 0.001). Both sST2 concentrations at presentation [hazard ratio (HR) 1.011, 95% confidence interval (CI) 1.005-1.016; p < 0.001] and on day 4 (HR 1.015, 95% CI 1.005-1.024; p = 0.003) were independent predictors of mortality. Patients with sST2 ≤ 76 ng/ml at presentation and ≤ 46 ng/ml on day 4 had the lowest mortality rates (3%), whereas those with both sST2 values above these cutoff points had the highest mortality (50%). C index and reclassification analyses demonstrated that the use of serial sST2 measures resulted in an improvement in the accuracy of mortality prediction. CONCLUSIONS: Among ADHF patients, sST2 concentrations tend to decrease following initiation of treatment and are prognostic both at presentation and during hospitalization. Serial sampling of sST2 adds prognostic information and may provide a basis for enhanced clinical decision making.

Full Text

Duke Authors

Cited Authors

  • Manzano-Fernández, S; Januzzi, JL; Pastor-Pérez, FJ; Bonaque-González, JC; Boronat-Garcia, M; Pascual-Figal, DA; Montalban-Larrea, S; Navarro-Peñalver, M; Andreu-Cayuelas, JM; Valdés, M

Published Date

  • 2012

Published In

Volume / Issue

  • 122 / 3

Start / End Page

  • 158 - 166

PubMed ID

  • 22832599

Pubmed Central ID

  • 22832599

Electronic International Standard Serial Number (EISSN)

  • 1421-9751

Digital Object Identifier (DOI)

  • 10.1159/000338800

Language

  • eng

Conference Location

  • Switzerland