STADE‐HF (sST2 As a help for management of HF): a pilot study

Abstract

Aims Biomarkers are not recommended until now to guide the management of patients with heart failure (HF). Soluble suppression of tumorigenicity 2 (sST2) appears as a promising biomarker. The current study considered pre-discharged sST2 values as a guide for medical management in patients admitted for acute HF decompensation, in an attempt to reduce hospital readmission. Methods and results STADE-HF was a blinded prospective randomized controlled trial and included 123 patients admitted for acute HF. They were randomized into the usual treatment group (unknown sST2 level) or the interventional treatment group, for whom sST2 level was known and used on Day 4 of hospitalization to guide the treatment. The primary endpoint was the readmission rate for any cause at 1 month. It occurred in 10 patients (19%) in the usual group and 18 (32%) in the sST2 group without statistical difference (P = 0.11). Post hoc analysis in the whole group shows that the mean duration of hospitalization was lower in patients with low sST2 (<37 ng/mL) at admission vs. high sST2 (8.5 ± 9.5 vs. 14.8 ± 14.9 days, respectively, P = 0.003). In addition, a decrease in sST2 greater than 18% is significantly associated with a lower readmission rate. Conclusions Soluble suppression of tumorigenicity 2-guided therapy over a short period of time does not reduce readmissions. However, sST2 was clearly associated with duration of hospitalization, and the decrease in sST2 was associated with decreased rehospitalizations. Long-term outcome using sST2-guided therapy deserves further investigations.

Soluble urokinase-type Plasminogen Activator Receptor Strongly Predicts Global Mortality in Acute Heart Failure Patients: Insight From the STADE-HF Registry

“…Numerous studies have confirmed that patients with HF present both local and systemic inflammation, and reported that elevated serum levels of CRP is clearly related to cardiovascular events and to mortality independently of natriuretic peptides [16][17][18]. Recently, sST2 has rapidly emerged because of its pluripotent role in inflammation, mechanical strain, remodeling and fibrosis [12]. sST2 appears promising in prognostic prediction of mortality in patients with chronic HF.…”

“…In previous study [ 6 ] we have confirmed that ST2 alone is an important risk factor for 42-month all-cause or cardiovascular mortality in chronic HF patients. However, the STADE-HF trial failed to demonstrate a reduction in cardiac rehospitalization after an admission for acute HF [ 12 ].…”

“…suPAR level was measured at patient admission, regardless of study group. Initially, we included 123 participants in the STADE-HF study [ 12 ]. Inside this population we could analyse the suPAR level in 47 patients from the control group and 50 patients in the sST2 group.…”

“…Materials & methods STADE-HF (sST2 as a help for management of diagnosis, evaluation and management of HF) was a single-blinded prospective randomized controlled trial conducted at University Hospital of Montpellier (Internal Medicine and Cardiology Departments) [12]. It included patients hospitalized for acute HF, and the sST2 was measured at J0 and J4.…”

Biomarkers in Heart Failure: Current and Future

“…Первичной конечной точкой стала частота повторных госпитализаций по любой причине через 1 мес. Достоверных различий по конечной точке между группами обнаружено не было, однако снижение концентрации sST2 более чем на 18 % ассоциировалось с более низкой частотой повторной госпитализации [22].…”