Prognostic value of sST2 added to BNP in acute heart failure with preserved or reduced ejection fraction

Friões, Fernando; Lourenço, Patrícia; Laszczyńska, Olga; Almeida, Pedro-Bernardo; Guimarães, João Tiago; Januzzi, James L.; Azevedo, Ana; Bettencourt, Paulo

doi:10.1007/s00392-015-0811-x

Cited by 54 publications

(35 citation statements)

References 34 publications

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“…16–24 In these patients with HFpEF, the median values for MMP-2 were ≈50% lower and PIIINP were similar to previously published referent control subjects. 5,31 …”

Section: Resultssupporting

confidence: 85%

“…In addition, biomarker data from this study of patients with HFpEF were compared with previously published groups of patients with HFpEF. 5,21–24 Finally, Gal-3 and sST-2 data in this study were compared with Food and Drug Administration approved partition values for risk stratification; these partition values were not specifically designed for risk stratification in HFpEF but were targeted to overall risk in generalized populations.…”

Section: Methodsmentioning

confidence: 99%

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Plasma Biomarkers Reflecting Profibrotic Processes in Heart Failure With a Preserved Ejection Fraction

Zile

Jhund

Baicu

et al. 2016

Circ: Heart Failure

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Background Heart failure with preserved ejection fraction is a clinical syndrome that has been associated with changes in the extracellular matrix. The purpose of this study was to determine whether profibrotic biomarkers accurately reflect the presence and severity of disease and underlying pathophysiology and modify response to therapy in patients with heart failure with preserved ejection fraction. Methods and Results Four biomarkers, soluble form of ST2 (an interleukin-1 receptor family member), galectin-3, matrix metalloproteinase-2, and collagen III N-terminal propeptide were measured in the Prospective Comparison of ARNI With ARB on Management of Heart Failure With Preserved Ejection Fraction (PARAMOUNT) trial at baseline, 12 and 36 weeks after randomization to valsartan or LCZ696. We examined the relationship between baseline biomarkers, demographic and echocardiographic characteristics, change in primary (change in N-terminal pro B-type natriuretic peptide) and secondary (change in left atrial volume) end points. The median (interquartile range) value for soluble form of ST2 (33 [24.6–48.1] ng/mL) and galectin 3 (17.8 [14.1–22.8] ng/mL) were higher, and for matrix metalloproteinase-2 (188 [155.5–230.6] ng/mL) lower, than in previously published referent controls; collagen III N-terminal propeptide (5.6 [4.3–6.9] ng/mL) was similar to referent control values. All 4 biomarkers correlated with severity of disease as indicated by N-terminal pro B-type natriuretic peptide, E/E′, and left atrial volume. Baseline biomarkers did not modify the response to LCZ696 for lowering N-terminal pro B-type natriuretic peptide; however, left atrial volume reduction varied by baseline level of soluble form of ST2 and galectin 3; patients with values less than the observed median (<33 ng/mL soluble form of ST2 and <17.8 ng/mL galectin 3) had reduction in left atrial volume, those above median did not. Although LCZ696 reduced N-terminal pro B-type natriuretic peptide, levels of the other 4 biomarkers were not affected over time. Conclusions In patients with heart failure with preserved ejection fraction, biomarkers that reflect collagen homeostasis correlated with the presence and severity of disease and underlying pathophysiology, and may modify the structural response to treatment.

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“…16–24 In these patients with HFpEF, the median values for MMP-2 were ≈50% lower and PIIINP were similar to previously published referent control subjects. 5,31 …”

Section: Resultssupporting

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Plasma Biomarkers Reflecting Profibrotic Processes in Heart Failure With a Preserved Ejection Fraction

Zile

Jhund

Baicu

et al. 2016

Circ: Heart Failure

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“…Hospital readmission after a hospitalization for acute heart failure is a major problem and although biomarkers can predict response to acute heart failure treatment [37], few valuable predictors of long-term outcome besides the natriuretic peptides have been proposed so far [38]. Moreover, studies investigating the predictive value of circulating miRNAs in (acute) heart failure patients in relation to adverse outcome are scarce.…”

Section: Discussionmentioning

confidence: 99%

Low circulating microRNA levels in heart failure patients are associated with atherosclerotic disease and cardiovascular-related rehospitalizations

et al. 2017

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ObjectiveCirculating microRNAs (miRNAs) have been implicated in both heart failure and atherosclerotic disease. The aim of this study was to examine associations between heart failure specific circulating miRNAs, atherosclerotic disease and cardiovascular-related outcome in patients with heart failure.MethodsThe levels of 11 heart failure-specific circulating miRNAs were compared in plasma of 114 heart failure patients with and without different manifestations of atherosclerotic disease. We then studied these miRNAs in relation to biomarkers associated to atherosclerosis and to cardiovascular-related rehospitalizations during 18 months of follow-up.ResultsAt least one manifestation of atherosclerotic disease was found in 70 (61%) of the heart failure patients. A consistent trend was found between an increasing number of manifestations of atherosclerosis (peripheral arterial disease in specific), and lower levels of miR-18a-5p, miR-27a-3p, miR-199a-3p, miR-223-3p and miR-652-3p (all P < 0.05). Target prediction and network analyses identified several interactions between miRNA targets and biomarkers related to inflammation, angiogenesis and endothelial dysfunction. Lower miRNA levels were associated with higher levels of these atherosclerosis-related biomarkers. In addition, lower miRNA levels were significantly associated with rehospitalizations due to cardiovascular causes within 18 months, with let-7i-5p as strongest predictor [HR 2.06 (95% CI 1.29–3.28), C-index 0.70, P = 0.002].ConclusionsA consistent pattern of lower levels of circulating miRNAs was found in heart failure patients with atherosclerotic disease, in particular peripheral arterial disease. In addition, lower levels of miRNAs were associated with higher levels of biomarkers involved in atherosclerosis and an increased risk of a cardiovascular-related rehospitalization.Electronic supplementary materialThe online version of this article (doi:10.1007/s00392-017-1096-z) contains supplementary material, which is available to authorized users.

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“…29,30) The predictive value of sST2 among dyspneic patients has been revealed in several studies. 23,31) However, the difference between AUCs concerning sST2 and NT-proBNP in prognosis is controversial. The PRIDE study demonstrated an AUC for sST2 of 0.80 with ROC analyses in predicting 1 year mortality (95%CI 0.75-0.84).…”

Section: Discussionmentioning

confidence: 99%

Predictors of Long-Term Mortality in Patients With Acute Heart Failure

et al. 2017

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SummaryTo investigate parameters which were related with long-term mortality in patients hospitalized for acute heart failure (AHF).A total of 287 patients with AHF presenting to the First Affiliated Hospital of Nanjing Medical University were enrolled into the registry from April 2012 to January 2015. The primary endpoint was all-cause mortality within 1 year; the association between variables and prognosis was assessed after 1 year.Among the 287 patients, 17 did not continue follow-up and 47 (17.4%) passed away. Baseline NT-proBNP and sST2 concentrations were higher amongst deceased than among survivors (P < 0.001). Serum sodium concentrations of patients who died were lower (P < 0.001). In receiver operator characteristics (ROC) analyses, the area under the curve (AUC) values for NT-proBNP, sST2, and serum sodium to predict 1-year mortality were 0.699 (95%CI 0.639-0.755), 0.692, (95%CI 0.634-0.747), and 0.694 (95%CI 0.634-0.750), respectively. The optimal cut-off points for NT-proBNP, sST2, and serum sodium were 2137.0 ng/L, 35.711 ng/mL, and 136.6 mmol/L, respectively. In Cox regression analysis, ln-transformed NT-proBNP (HR 1.546, P = 0.039), ln-transformed sST2 (HR1.542, P = 0.049), and serum sodium (HR 0.880, P = 0.000) values reliably predicted long-term mortality after multivariable adjustment.In patients with acute heart failure, NT-proBNP, sST2 and serum sodium are potential predictors of 1-year mortality. (Int Heart J 2017; 58: 409-415)

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Prognostic value of sST2 added to BNP in acute heart failure with preserved or reduced ejection fraction

Abstract: sST2 provides robust prognostic information in acute heart failure with HFrEF, while this pattern was less clear in HFpEF. When sST2 was measured together with BNP, it improved prognostic accuracy in both groups, more clearly in HFrEF.

Cited by 54 publications

References 34 publications

Plasma Biomarkers Reflecting Profibrotic Processes in Heart Failure With a Preserved Ejection Fraction

Plasma Biomarkers Reflecting Profibrotic Processes in Heart Failure With a Preserved Ejection Fraction

Low circulating microRNA levels in heart failure patients are associated with atherosclerotic disease and cardiovascular-related rehospitalizations

Predictors of Long-Term Mortality in Patients With Acute Heart Failure

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