Measurement of the interleukin family member ST2 in patients with acute dyspnea: results from the PRIDE (Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department) study.

Published

Journal Article

The aim of this study was to examine the value of measurement of the interleukin-1 receptor family member ST2 in patients with dyspnea.Concentrations of ST2 have been reported to be elevated in patients with heart failure (HF).Five hundred ninety-three dyspneic patients with and without acute destabilized HF presenting to an urban emergency department were evaluated with measurements of ST2 concentrations. Independent predictors of death at 1 year were identified.Concentrations of ST2 were higher among those with acute HF compared with those without (0.50 vs. 0.15 ng/ml; p < 0.001), although amino-terminal pro-brain natriuretic peptide (NT-proBNP) was superior to ST2 for diagnosis of acute HF. Median concentrations of ST2 at presentation to the emergency department were higher among decedents than survivors at 1 year (1.08 vs. 0.18 ng/ml; p < 0.001), and in multivariable analyses, an ST2 concentration > or =0.20 ng/ml strongly predicted death at 1 year in dyspneic patients as a whole (HR = 5.6, 95% confidence interval [CI] 2.2 to 14.2; p < 0.001) as well as those with acute HF (hazard ratio [HR] = 9.3, 95% CI 1.3 to 17.8; p = 0.03). This risk associated with an elevated ST2 in dyspneic patients with and without HF appeared early and was sustained at 1 year after presentation (log-rank p value <0.001). A multi-marker approach with both ST2 and NT-proBNP levels identified subjects with the highest risk for death.Among dyspneic patients with and without acute HF, ST2 concentrations are strongly predictive of mortality at 1 year and might be useful for prognostication when used alone or together with NT-proBNP.

Full Text

Duke Authors

Cited Authors

  • Januzzi, JL; Peacock, WF; Maisel, AS; Chae, CU; Jesse, RL; Baggish, AL; O'Donoghue, M; Sakhuja, R; Chen, AA; van Kimmenade, RRJ; Lewandrowski, KB; Lloyd-Jones, DM; Wu, AHB

Published Date

  • August 2007

Published In

Volume / Issue

  • 50 / 7

Start / End Page

  • 607 - 613

PubMed ID

  • 17692745

Pubmed Central ID

  • 17692745

Electronic International Standard Serial Number (EISSN)

  • 1558-3597

International Standard Serial Number (ISSN)

  • 0735-1097

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2007.05.014

Language

  • eng