Soluble ST2 for Predicting Sudden Cardiac Death in Patients With Chronic Heart Failure and Left Ventricular Systolic Dysfunction

Pascual-Figal, Domingo A.; Ordóñez-Llanos, Jordi; Tornel, Pedro L.; Vázquez, Rafael; Puig, Teresa; Valdés, Mariano; Cinca, Juan; Luna, Antoni Bayés de; Bayés‐Genís, Antoni; Investigators, Music

doi:10.1016/j.jacc.2009.07.041

Cited by 221 publications

(154 citation statements)

References 38 publications

Supporting

Mentioning

127

Contrasting

Unclassified

Order By: Relevance

“…The circulating biomarker, soluble ST2 (sST2) has been shown to be a powerful independent prognosticator for patients with acute myocardial infarction (AMI)1, 2 as well as acute decompensated3, 4 and chronic5, 6, 7, 8, 9 HF. sST2, a member of the interleukin (IL)‐1 receptor‐like family of proteins, is released in response to myocyte stretch, and functions as a decoy receptor, neutralizing its ligand, IL‐33.…”

Section: Introductionmentioning

confidence: 99%

Soluble ST2 for Prediction of Heart Failure and Cardiovascular Death in an Elderly, Community‐Dwelling Population

Parikh

Seliger

Christenson

et al. 2016

JAHA

View full text Add to dashboard Cite

BackgroundSoluble ST2 (sST2), a marker of myocyte stretch and fibrosis, has prognostic value in many cardiovascular diseases. We hypothesized that sST2 levels are associated with incident heart failure (HF), including subtypes of preserved (HFpEF) and reduced (HFrEF) ejection fraction, and cardiovascular death.Methods and ResultsBaseline serum sST2 was measured in 3915 older, community‐dwelling subjects from the Cardiovascular Health Study without prevalent HF. sST2 levels were associated with older age, male sex, black race, traditional cardiovascular risk factors, other biomarkers of inflammation, cardiac stretch, myocardial injury, and fibrosis, and abnormal echocardiographic parameters. In longitudinal analysis, greater sST2 was associated with a higher risk of incident HF and cardiovascular death; however, in multivariate models adjusting for other cardiac risk factors and the cardiac‐specific biomarker, N‐terminal pro–type B natriuretic peptide, these associations were attenuated. In these models, an sST2 level above the US Food and Drug Administration–approved cut‐off value (>35 ng/mL) was significantly associated with incident HF (hazard ratio [HR], 1.20; 95% CI, 1.02–1.43) and cardiovascular death (HR, 1.21; 95% CI, 1.02–1.44), and greater sST2 was continuously associated with cardiovascular death (per 1‐ln increment: HR, 1.24; 95% CI, 1.02–1.50). sST2 was not associated with the HF subtypes of HFpEF and HFrEF in adjusted analysis. Addition of sST2 to existing risk models of HF and cardiovascular death modestly improved discrimination and reclassification into a higher risk.ConclusionsThe predictive value of sST2 for HF of all subtypes and cardiovascular death is modest in an elderly population despite strong cross‐sectional associations with risk factors and underlying cardiac pathology.

show abstract

Section: Introductionmentioning

confidence: 99%

Soluble ST2 for Prediction of Heart Failure and Cardiovascular Death in an Elderly, Community‐Dwelling Population

Parikh

Seliger

Christenson

et al. 2016

JAHA

View full text Add to dashboard Cite

show abstract

“…So far, only few studies have investigated GDF‐15 and sST2 in patients with non‐ischaemic DCM 21, 37. Although an association of both GDF‐15 and sST2 with sudden cardiac death was previously demonstrated, non‐ischaemic DCM represented one‐third to one‐half of these cohorts 24, 25, 37. Because of different aetiologies of the disease leading to different risks of AD,5, 8 it is of paramount importance to separately investigate ischaemic and non‐ischaemic heart failure patients.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammation and myocardial fibrosis, with subsequent ventricular remodelling and impairment of systolic function, are important pathophysiological mechanisms for VTs in patients with DCM 19, 20. Both GDF‐15 and sST2 show strong correlations with myocardial stress and fibrosis,21, 22, 23 and have been associated with sudden cardiac death in DCM 24, 25…”

Section: Introductionmentioning

confidence: 99%

GDF‐15 is a better complimentary marker for risk stratification of arrhythmic death in non‐ischaemic, dilated cardiomyopathy than soluble ST2

Stojković

Kaider

Koller

et al. 2018

J Cellular Molecular Medi

View full text Add to dashboard Cite

Growth differentiation factor (GDF)‐15 and soluble ST2 (sST2) are established prognostic markers in acute and chronic heart failure. Assessment of these biomarkers might improve arrhythmic risk stratification of patients with non‐ischaemic, dilated cardiomyopathy (DCM) based on left ventricular ejection fraction (LVEF). We studied the prognostic value of GDF‐15 and sST2 for prediction of arrhythmic death (AD) and all‐cause mortality in patients with DCM. We prospectively enrolled 52 patients with DCM and LVEF ≤ 50%. Primary end‐points were time to AD or resuscitated cardiac arrest (RCA), and secondary end‐point was all‐cause mortality. The median follow‐up time was 7 years. A cardiac death was observed in 20 patients, where 10 patients had an AD and 2 patients had a RCA. One patient died a non‐cardiac death. GDF‐15, but not sST2, was associated with increased risk of the AD/RCA with a hazard ratio (HR) of 2.1 (95% CI = 1.1‐4.3; P = .031). GDF‐15 remained an independent predictor of AD/RCA after adjustment for LVEF with adjusted HR of 2.2 (95% CI = 1.1‐4.5; P = .028). Both GDF‐15 and sST2 were independent predictors of all‐cause mortality (adjusted HR = 2.4; 95% CI = 1.4‐4.2; P = .003 vs HR = 1.6; 95% CI = 1.05‐2.7; P = .030). In a model including GDF‐15, sST2, LVEF and NYHA functional class, only GDF‐15 was significantly associated with the secondary end‐point (adjusted HR = 2.2; 95% CI = 1.05‐5.2; P = .038). GDF‐15 is superior to sST2 in prediction of fatal arrhythmic events and all‐cause mortality in DCM. Assessment of GDF‐15 could provide additional information on top of LVEF and help identifying patients at risk of arrhythmic death.

show abstract

“…However, there are still only a few studies about sST2 in patients with stable CHF. Pascual-Figal et al 16 confirmed that sST2 levels (cut-off point, 0.15 ng/ml) are predictive of sudden cardiac death in patients with stable CHF and LV systolic dysfunction (LVEF ≤45%) at 1-year follow-up.The higher cut-off point obtained in our study (0.296 ng/ml) was presumably the result of poorer LV systolic function in the study population. Ky et al 17 conducted an analysis of 1141 outpatients with systolic CHF (LVEF = 32.2% ±17%) and showed that higher sST2 levels on enrollment were associated with a significantly increased risk of all-cause death or cardiac transplantation after a median follow-up of 2.8 years.…”

mentioning

confidence: 90%

Single sST2 protein measurement predicts adverse outcomes at 1‑year follow‑up in patients with chronic heart failure

Sobczak¹,

Wojtczak-Soska²,

Ciurus³

et al. 2014

Polish Archives of Internal Medicine

View full text Add to dashboard Cite

Soluble ST2 for Predicting Sudden Cardiac Death in Patients With Chronic Heart Failure and Left Ventricular Systolic Dysfunction

Abstract: Elevated sST2 concentrations are predictive of SCD in patients with chronic HF and provide complementary information to NT-proBNP levels. A combined biomarker approach may have an impact on clinical decision-making.

Cited by 221 publications

References 38 publications

Soluble ST2 for Prediction of Heart Failure and Cardiovascular Death in an Elderly, Community‐Dwelling Population

Soluble ST2 for Prediction of Heart Failure and Cardiovascular Death in an Elderly, Community‐Dwelling Population

GDF‐15 is a better complimentary marker for risk stratification of arrhythmic death in non‐ischaemic, dilated cardiomyopathy than soluble ST2

Single sST2 protein measurement predicts adverse outcomes at 1‑year follow‑up in patients with chronic heart failure

Contact Info

Product

Resources

About