Key result
Admission sST2 levels predicted 1-year adverse events in heart failure patients (OR 4.384; 95% CI 1.661-11.570), providing distinct prognostic information across different ejection fraction groups.
Why the study?
Do sST2 and NT-proBNP levels at admission predict 1-year adverse events in patients with different types of heart failure?
Cohort (n=164)
No
Do sST2 and NT-proBNP levels at admission predict 1-year adverse events in patients with different types of heart failure?
Odds Ratio: 4.384 (95% CI 1.661–11.57)
sST2 and NT-proBNP measured at admission provide significant and complementary prognostic value for predicting 1-year adverse events across different heart failure phenotypes.
May enhance 1-year risk prediction when combined with NT-proBNP across HF subtypes; leaves open whether it should guide therapy.
OBJECTIVE: The aim of this study was to compare sST2 at admission with N-terminal pro B-type natriuretic peptide (NT-proBNP) in prognostic accuracy among different types of heart failure (HF) and clarifying the enhanced prognostic value in patients with HF by the combination of the two biomarkers. METHODS AND RESULTS: A total of 164 consecutive patients admitted to our institution for HF were divided into three groups of HF with reduced ejection fraction (HFrEF), HF with mid-range ejection fraction (HFmrEF) and HF with preserved ejection fraction (HFpEF). Circulating sST2 and NT-proBNP were measured using the enzyme-linked immunosorbent assay (ELISA). The sST2 level was only significantly higher in HFrEF when compared with HFpEF. At ROC analysis to one-year adverse events, only sST2 showed predictive value in HFmrEF with an optimal cut-off value of 147.66 ng/ml (AUC 0.697, p = .045, sensitivity 75%, specificity 75.8%), while both NT-proBNP and sST2 showed a significant predictive value in HFpEF (p = .036 vs .042; AUC 0.683, sensitivity 71.4%, specificity 55.6%; AUC 0.677, sensitivity 64.3%, specificity 83.3%) with an optimal cut-off value of 1054.50 pg/ml and 117.80 ng/ml. Multivariate regression analysis suggested that sST2 and NT-proBNP could be biomarkers for predicting 1-year adverse events of HF (OR = 4.384, 95% CI = 1.661-11.570 vs. OR = 3.451, 95% CI = 1.254-9.497). Adverse events occurred frequently within one year both in sST2 and in NT-proBNP above the median. CONCLUSIONS: sST2 can provide different prognostic information in distinct types of HF, and even be superior to NT-proBNP. sST2 combined with NT-proBNP can improve predicting accuracy.
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Huang et al. (2017) conducted a cohort in Heart failure (n=164). sST2 vs. NT-proBNP was evaluated on 1-year adverse events (OR 4.384, 95% CI 1.661-11.570). Admission sST2 levels predicted 1-year adverse events in heart failure patients (OR 4.384; 95% CI 1.661-11.570), providing distinct prognostic information across different ejection fraction groups.
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