Stretch, Injury and Inflammation Markers Evaluation to Predict Clinical Outcomes After Implantable Cardioverter Defibrillator Therapy in Heart Failure Patients With Metabolic Syndrome
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Key result
Elevated ST2 protein levels strongly predicted survival outcomes after appropriate ICD therapy (HR 4.297) in heart failure patients with metabolic syndrome.
Why the study?
Does the presence of metabolic syndrome and elevated ST2 protein predict worse clinical outcomes and appropriate ICD shocks in heart failure patients receiving primary prevention ICDs?
Population
206 consecutive adults affected by ischemic cardiomyopathy with severe reduction of LVEF, NYHA functional…
Comparison
Presence of Metabolic Syndrome and elevated… vs Patients without Metabolic Syndrome and/or…
Design
Cohort
Follow-up
12 months
Authors
Discussion
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Member takes
Implication
Elevated ST2 may refine risk stratification in HF with metabolic syndrome; hypothesis-generating and requires prospective validation.
Study Design
Type
Cohort (n=206)
Multicenter
Yes
Structured PICO
Does the presence of metabolic syndrome and elevated ST2 protein predict worse clinical outcomes and appropriate ICD shocks in heart failure patients receiving primary prevention ICDs?
P
Population
206 adults aged 18-75 years with stable ischemic heart failure and LVEF <35% receiving an ICD for primary prevention, followed for 12 months.
E
Exposure
Presence of Metabolic Syndrome (MS) and elevated baseline serum biomarkers (specifically ST2 protein, BNP, CRP, and TnI).
C
Comparator
Patients without Metabolic Syndrome (no MS) and/or patients in lower quartiles of serum biomarkers.
O
Outcome
All-cause mortality, cardiac deaths, hospitalization for heart failure, appropriate ICD therapy, inappropriate ICD therapy, and survival after appropriate ICD therapy evaluated at 6 and 12 months follow-up.hard clinical
Main Result
Hazard Ratio: 4.297 (95% CI 1.985–9.302)
p-value: p=0.001
In heart failure patients with metabolic syndrome receiving primary prevention ICDs, elevated ST2 protein levels independently predict appropriate ICD therapies and worse survival.
Limitations
- Observational study design
- Relatively small sample size
- Short follow-up duration of 12 months
Cite This Study
Sardu et al. (2018) conducted a cohort in Heart failure with Metabolic Syndrome (n=206). Elevated ST2 protein vs. Lower ST2 protein was evaluated on Survival after appropriate ICD therapy (HR 4.297, 95% CI 1.985-9.302, p=0.001). Elevated ST2 protein levels strongly predicted survival outcomes after appropriate ICD therapy (HR 4.297) in heart failure patients with metabolic syndrome.
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