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Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes.

Publication ,  Journal Article
Felker, GM; Fiuzat, M; Thompson, V; Shaw, LK; Neely, ML; Adams, KF; Whellan, DJ; Donahue, MP; Ahmad, T; Kitzman, DW; Piña, IL; Zannad, F ...
Published in: Circ Heart Fail
November 2013

BACKGROUND: ST2 is involved in cardioprotective signaling in the myocardium and has been identified as a potentially promising biomarker in heart failure (HF). We evaluated ST2 levels and their association with functional capacity and long-term clinical outcomes in a cohort of ambulatory patients with HF enrolled in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) study-a multicenter, randomized study of exercise training in HF. METHODS AND RESULTS: HF-ACTION randomized 2331 patients with left ventricular ejection fraction <0.35 and New York Heart Association class II to IV HF to either exercise training or usual care. ST2 was analyzed in a subset of 910 patients with evaluable plasma samples. Correlations and Cox models were used to assess the relationship among ST2, functional capacity, and long-term outcomes. The median baseline ST2 level was 23.7 ng/mL (interquartile range, 18.6-31.8). ST2 was modestly associated with measures of functional capacity. In univariable analysis, ST2 was significantly associated with death or hospitalization (hazard ratio, 1.48; P<0.0001), cardiovascular death or HF hospitalization (hazard ratio, 2.14; P<0.0001), and all-cause mortality (hazard ratio, 2.33; P<0.0001; all hazard ratios for log2 ng/mL). In multivariable models, ST2 remained independently associated with outcomes after adjustment for clinical variables and amino-terminal pro-B-type natriuretic peptide. However, ST2 did not add significantly to reclassification of risk as assessed by changes in the C statistic, net reclassification improvement, and integrated discrimination improvement. CONCLUSIONS: ST2 was modestly associated with functional capacity and was significantly associated with outcomes in a well-treated cohort of ambulatory patients with HF although it did not significantly affect reclassification of risk. CLINICAL TRIAL INFORMATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00047437.

Duke Scholars

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

November 2013

Volume

6

Issue

6

Start / End Page

1172 / 1179

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Time Factors
  • Stroke Volume
  • Receptors, Interleukin-1
  • Receptors, Cell Surface
  • Prognosis
  • Outpatients
  • Middle Aged
  • Male
  • Interleukin-1 Receptor-Like 1 Protein
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Felker, G. M., Fiuzat, M., Thompson, V., Shaw, L. K., Neely, M. L., Adams, K. F., … O’Connor, C. M. (2013). Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes. Circ Heart Fail, 6(6), 1172–1179. https://doi.org/10.1161/CIRCHEARTFAILURE.113.000207
Felker, G Michael, Mona Fiuzat, Vivian Thompson, Linda K. Shaw, Megan L. Neely, Kirkwood F. Adams, David J. Whellan, et al. “Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes.Circ Heart Fail 6, no. 6 (November 2013): 1172–79. https://doi.org/10.1161/CIRCHEARTFAILURE.113.000207.
Felker GM, Fiuzat M, Thompson V, Shaw LK, Neely ML, Adams KF, et al. Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes. Circ Heart Fail. 2013 Nov;6(6):1172–9.
Felker, G. Michael, et al. “Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes.Circ Heart Fail, vol. 6, no. 6, Nov. 2013, pp. 1172–79. Pubmed, doi:10.1161/CIRCHEARTFAILURE.113.000207.
Felker GM, Fiuzat M, Thompson V, Shaw LK, Neely ML, Adams KF, Whellan DJ, Donahue MP, Ahmad T, Kitzman DW, Piña IL, Zannad F, Kraus WE, O’Connor CM. Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes. Circ Heart Fail. 2013 Nov;6(6):1172–1179.

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

November 2013

Volume

6

Issue

6

Start / End Page

1172 / 1179

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Time Factors
  • Stroke Volume
  • Receptors, Interleukin-1
  • Receptors, Cell Surface
  • Prognosis
  • Outpatients
  • Middle Aged
  • Male
  • Interleukin-1 Receptor-Like 1 Protein