title: Increased plasma concentrations of soluble ST2 are predictive for 1-year mortality in patients with acute destabilized heart failure.
abstract: BACKGROUND
  The soluble isoform of the interleukin-1 receptor family member ST2 (sST2) has been implicated in heart failure. The aim of the present study was to evaluate the capability of sST2 as a prognostic marker in patients with acute destabilized heart failure.
  
  
  METHODS
  sST2 plasma concentrations were obtained in 137 patients with acute destabilized heart failure attending the emergency department of a tertiary care hospital. The endpoint was defined as all-cause mortality, and the study participants were followed up for 365 days.
  
  
  RESULTS
  Of the 137 patients enrolled, 41 died and 96 survived during follow-up. At baseline the median sST2 plasma concentration was significantly higher in the patients who died than in those who survived (870 vs 342 ng/L, P <0.001). Kaplan-Meier curve analyses demonstrated that the risk ratios for mortality were 2.45 (95% CI, 0.88-6.31; P = 0.086) and 6.63 (95% CI, 2.55-10.89; P <0.001) in the second tercile (sST2, 300-700 ng/L; 11 deaths vs 34 survivors) and third tercile (sST2, >700 ng/L; 25 deaths vs 21 survivors) of sST2 plasma concentrations compared with the first tercile (sST2, < or =300 ng/L; 5 deaths vs 41 survivors). In multivariable Cox proportional-hazards regression analyses, an sST2 plasma concentration in the upper tercile was a strong and independent predictor of all-cause mortality.
  
  
  CONCLUSIONS
  Increased sST2 concentrations determined in plasma samples drawn from patients with acute destabilized heart failure at their initial presentation indicate increased risk of future mortality. Increased sST2 plasma concentrations are independently and strongly associated with one-year all-cause mortality in these patients.
authors: Department of Laboratory Medicine, Konventhospital Barmherzige Brueder, Linz, Austria. thomas.mueller@bs-lab.at
authors: Thomas
authors: T
authors: Mueller
authors: Benjamin
authors: B
authors: Dieplinger
authors: Alfons
authors: A
authors: Gegenhuber
authors: Werner
authors: W
authors: Poelz
authors: Richard
authors: R
authors: Pacher
authors: Meinhard
authors: M
authors: Haltmayer
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011956:Receptors, Cell Surface / Q000097:blood*; D012016:Reference Values; D015996:Survival Rate
chemical_list: D015415:Biomarkers; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D011956:Receptors, Cell Surface