What is the clinical evidence from this study?

Study design: Cohort. Population: Nonvalvular Atrial Fibrillation (n=290). Intervention: Elevated soluble ST2 (sST2 ≥ 219.3 ng/L) vs. sST2 < 219.3 ng/L. Primary outcome: Occurrence of heart failure (HR 5.88, 95% CI 1.42-24.45, p=0.02).

What question did this study set out to answer?

To evaluate circulating soluble ST2 levels in patients with nonvalvular atrial fibrillation and determine whether this biomarker predicts the future onset of heart failure.

December 26, 2017International Heart JournalOpen Access

Soluble ST2 in Patients with Nonvalvular Atrial Fibrillation and Prediction of Heart Failure

Q: What are the key findings of this study?

Elevated plasma soluble ST2 levels (≥ 219.3 ng/L) independently predicted the occurrence of heart failure in patients with nonvalvular atrial fibrillation (HR 5.88).

Q: What question did this study set out to answer?

To evaluate circulating soluble ST2 levels in patients with nonvalvular atrial fibrillation and determine whether this biomarker predicts the future onset of heart failure.

View Full Paper

Ask AI

Bookmark

Key result

Elevated plasma soluble ST2 levels (≥ 219.3 ng/L) independently predicted the occurrence of heart failure in patients with nonvalvular atrial fibrillation (HR 5.88).

Why the study?

Does elevated soluble ST2 predict the occurrence of heart failure in patients with nonvalvular atrial fibrillation?

Population

174 inpatients with nonvalvular atrial fibrillation and 116 age-matched patients with sinus rhythm…

Comparison

Elevated plasma soluble ST2 levels vs Lower plasma sST2 levels and sinus rhythm controls

Design

Cohort, Laboratory scientist blinded to clinical information for ST2 assay

Follow-up

median 6 months

Authors

CCChangxi ChenChina Agricultural University XQXiang QuShenzhen University ZGZhan GaoWannan Medical College

Discussion

Member takes

Implication

Should not yet change HF risk assessment in nonvalvular AF; hypothesis-generating and requires prospective validation.

Key Points

To evaluate circulating soluble ST2 levels in patients with nonvalvular atrial fibrillation and determine whether this biomarker predicts the future onset of heart failure.
Enrolled 174 subjects with nonvalvular atrial fibrillation (62.1% men; mean age 65.6 ± 10.3 years; categorized as paroxysmal or persistent AF) and 116 age-matched controls in sinus rhythm.
Measured plasma soluble ST2 concentrations using an electrochemiluminescence-based immunoassay.
Followed patients for a median duration of 6 months and identified independent predictors of incident heart failure using Cox proportional hazard analysis.
Soluble ST2 levels were significantly elevated in both persistent AF (P < 0.05) and paroxysmal AF (P < 0.05) compared to sinus rhythm controls, with no significant difference observed between AF subtypes.
Soluble ST2 concentrations showed a modest positive correlation with left atrial diameter (r = 0.21; P < 0.01).
During the 6-month follow-up, 43 subjects with nonvalvular AF developed heart failure, with both soluble ST2 and left atrial diameter identified as independent predictors of heart failure on Cox proportional hazard analysis.

Study Design

Type

Cohort (n=290)

Multicenter

Structured PICO

Does elevated soluble ST2 predict the occurrence of heart failure in patients with nonvalvular atrial fibrillation?

Population

290 inpatients (174 with nonvalvular atrial fibrillation and 116 with sinus rhythm), with a mean age of 65.6 years and 37% female, followed for a median of 6 months to evaluate sST2 as a predictor of heart failure.

Exposure

Elevated plasma soluble ST2 (sST2) levels (≥ 219.3 ng/L)

Comparator

Lower plasma sST2 levels (< 219.3 ng/L) and sinus rhythm controls

Outcome

Occurrence of heart failure during follow-uphard clinical

Main Result

Hazard Ratio: 5.88 (95% CI 1.42–24.45)

p-value: p=0.02

Elevated plasma soluble ST2 levels are independently associated with an increased risk of developing heart failure in patients with nonvalvular atrial fibrillation.

Limitations

Exclusion of NYHA III patients limits generalizability to the broader AF population
Small sample size due to the single-center design
A highly sensitive assay for sST2 measurement was not used
Short follow-up period
Single measurement of sST2 without serial testing
Potential impacts of cardiovascular medications on hemodynamics or biomarkers could not be completely excluded
Excluded NYHA ≥ III patients
Single-center design with limited sample size
Highly sensitive assay for sST2 measurement was not used
Single measurement of sST2 rather than serial testing

Cite This Study

Chen et al. (2017) conducted a cohort in Nonvalvular Atrial Fibrillation (n=290). Elevated soluble ST2 (sST2 ≥ 219.3 ng/L) vs. sST2 < 219.3 ng/L was evaluated on Occurrence of heart failure (HR 5.88, 95% CI 1.42-24.45, p=0.02). Elevated plasma soluble ST2 levels (≥ 219.3 ng/L) independently predicted the occurrence of heart failure in patients with nonvalvular atrial fibrillation (HR 5.88).

synapsesocial.com/papers/6a99dffb410dbbc082f50be0 https://doi.org/10.1536/ihj.16-520

Topics

Heart failure HFrEF treatment Atrial fibrillation Persistent AF management Echocardiography

View Full Paper

Ask AI

Bookmark

Soluble ST2 in Patients with Nonvalvular Atrial Fibrillation and Prediction of Heart Failure

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Soluble ST2 in Patients with Nonvalvular Atrial Fibrillation and Prediction of Heart Failure

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider