Key result
Discharge sST2 concentrations ≥37.8 ng/ml strongly predicted cardiovascular death or heart failure rehospitalization, showing superior prognostic value over copeptin.
Why the study?
Does discharge sST2 concentration better predict adverse cardiovascular events in patients with acute decompensated heart failure compared to copeptin or NT-proBNP?
Cohort (n=159)
No
Does discharge sST2 concentration better predict adverse cardiovascular events in patients with acute decompensated heart failure compared to copeptin or NT-proBNP?
Discharge sST2 levels serve as a more robust independent predictor of long-term cardiovascular outcomes in acute decompensated heart failure than copeptin.
Answers are grounded in this paper and cite their sources.
May enhance discharge risk stratification in acute decompensated heart failure; hypothesis-generating for sST2 superiority over copeptin pending validation.
PURPOSE: To assess the suppression of tumorogenicity 2 (ST2) and copeptin significance for risk stratification of patient (pts) with acute decompensated heart failure (ADHF) during long-term follow-up compared with traditional risk factors. METHODS: We included in a prospective study 159 pts with ADHF. Blood samples to determine copeptin, sST2, NT-proBNP and hsTnT concentration were collected at admission and at discharge from the hospital. Serial determination of biomarker concentration was performed at 3, 6 and 12 months of follow-up. The combined primary end point of the trial included cardiovascular (CV) death, hospitalization due to HF, episodes of HF deterioration requiring additional intravenous diuretics and CV death with successful resuscitation. RESULTS: During 1-year follow-up (295.3±113.2 days) 56 pts (35.2%) had 78 (49.1%) cardiovascular events. Biomarker concentrations in low risk pts (without CV events) were significantly lower compared with high risk pts (with CV events). Discharge copeptin and NT-proBNP values were comparable for pts risk stratification: AUC=0.727 (95% CI 0.637-0.816), р.
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Skvortsov et al. (2017) conducted a cohort in Acute Decompensated Heart Failure (ADHF) with LVEF <40% (n=159). Elevated discharge sST2 (soluble suppression of tumorogenicity 2) concentration (≥37.8 ng/ml) vs. Discharge sST2 <37.8 ng/ml or other biomarkers (copeptin, NT-proBNP) was evaluated on Composite of cardiovascular death, first hospitalization for HF decompensation, HF decompensation requiring IV diuretics, and cardiovascular death with successful resuscitation (OR 6.755, 95% CI 3.026-15.082, p=<0.0001). Discharge sST2 concentrations ≥37.8 ng/ml strongly predicted cardiovascular death or heart failure rehospitalization, showing superior prognostic value over copeptin.
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