Soluble ST2 in Heart Failure: A Clinical Role beyond B-Type Natriuretic Peptide

Riccardi, Mauro; Myhre, Peder L.; Zelniker, Thomas A.; Metra, Marco; Januzzi, James L.; Inciardi, Riccardo M.

doi:10.3390/jcdd10110468

Cited by 6 publications

(2 citation statements)

References 82 publications

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“…NT-proBNP and soluble suppression of tumourigenicity 2 (sST2) are biological markers universally acknowledged to be relevant to the diagnosis and prognosis of HF [23,24]. Although, as expected, elevated levels were observed in our deceased patient population, both at baseline and follow-up analyses, surprisingly, they did not appear to be of statistical significance in determining a prognostic score.…”

Section: Discussionsupporting

confidence: 58%

Predicting One-Year Mortality after Discharge Using Acute Heart Failure Score (AHFS)

Magaldi,

Nogue,

Molinari

et al. 2024

JCM

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Background: Acute heart failure (AHF) represents a leading cause of unscheduled hospital stays, frequent rehospitalisations, and mortality worldwide. The aim of our study was to develop a bedside prognostic tool, a multivariable predictive risk score, that is useful in daily practice, thus providing an early prognostic evaluation at admission and an accurate risk stratification after discharge in patients with AHF. Methods: This study is a subanalysis of the STADE HF study, which is a single-centre, prospective, randomised controlled trial enrolling 123 patients admitted to hospital for AHF. Here, 117 patients were included in the analysis, due to data exhaustivity. Regression analysis was performed to determine predictive variables for one-year mortality and/or rehospitalisation after discharge. Results: During the first year after discharge, 23 patients died. After modellisation, the variables considered to be of prognostic relevance in terms of mortality were (1) non-ischaemic aetiology of HF, (2) elevated creatinine levels at admission, (3) moderate/severe mitral regurgitation, and (4) prior HF hospitalisation. We designed a linear model based on these four independent predictive variables, and it showed a good ability to score and predict patient mortality with an AUC of 0.84 (95%CI: 0.76–0.92), thus denoting a high discriminative ability. A risk score equation was developed. During the first year after discharge, we observed as well that 41 patients died or were rehospitalised; hence, while searching for a model that could predict worsening health conditions (i.e., death and/or rehospitalisation), only two predictive variables were identified: non-ischaemic HF aetiology and previous HF hospitalisation (also included in the one-year mortality model). This second modellisation showed a more discrete discriminative ability with an AUC of 0.67 (95% C.I. 0.59–0.77). Conclusions: The proposed risk score and model, based on readily available predictive variables, are promising and useful tools to assess, respectively, the one-year mortality risk and the one-year mortality and/or rehospitalisations in patients hospitalised for AHF and to assist clinicians in the management of patients with HF aiming at improving their prognosis.

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Section: Discussionsupporting

confidence: 58%

Predicting One-Year Mortality after Discharge Using Acute Heart Failure Score (AHFS)

Magaldi,

Nogue,

Molinari

et al. 2024

JCM

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“…From this perspective, the combined assessment of biomarkers may improve risk stratification. The measurement of soluble (s)ST2 was recently shown to improve the prognostic accuracy when combined with NT-proBNP measurement [50]. Especially in patients with chronic kidney disease, sST2 was shown to be associated with the risk of developing HF, including 3314 patients [51].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Prognostic Value of Aminoterminal Prohormone of Brain Natriuretic Peptide in Heart Failure with Mildly Reduced Ejection Fraction Stratified by the Degree of Renal Dysfunction

Schupp,

Abumayyaleh,

Weidner

et al. 2024

JCM

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Limited data concerning the diagnostic and prognostic value of blood-derived biomarkers in heart failure with mildly reduced ejection fraction (HFmrEF) is available. This study investigates the diagnostic and prognostic value of aminoterminal prohormone of brain natriuretic peptide (NT-proBNP) in patients with HFmrEF, stratified by the estimated glomerular filtration rate (eGFR). Consecutive patients with HFmrEF were retrospectively included at one institution from 2016 to 2022. First, the diagnostic value of NT-proBNP for acute decompensated heart failure (ADHF) was tested. Thereafter, the prognostic value of NT-proBNP levels was tested for 30-months all-cause mortality in patients with ADHF. From a total of 755 patients hospitalized with HFmrEF, the rate of ADHF was 42%. Patients with ADHF revealed higher NT-proBNP levels compared to patients without (median 5394 pg/mL vs. 1655 pg/mL; p = 0.001). NT-proBNP was able to discriminate ADHF with an area under the curve (AUC) of 0.777 (p = 0.001), with the highest AUC in patients with eGFR ≥ 60 mL/min (AUC = 0.800; p = 0.001), and no diagnostic value was seen in eGFR < 30 mL/min (AUC = 0.576; p = 0.210). Patients with NT-proBNP levels > 3946 pg/mL were associated with higher rates of all-cause mortality at 30 months (57.7% vs. 34.4%; HR = 2.036; 95% CI 1.423–2.912; p = 0.001), even after multivariable adjustment (HR = 1.712; 95% CI 1.166–2.512; p = 0.006). In conclusion, increasing NT-proBNP levels predicted the risk of ADHF and all-cause mortality in patients with HFmrEF and preserved renal function; however, NT-proBNP levels were not predictive in patients with HFmrEF and eGFR < 30 mL/min.

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