Serial sampling of ST2 predicts 90-day mortality following destabilized heart failure.
BACKGROUND
To prospectively determine the prognostic utility of serial sampling of the interleukin-1 receptor family member, ST2, for predicting 90-day mortality in patients with heart failure (HF) admitted to a Veteran Affairs Medical Center.


RESULTS
A total 150 patients hospitalized with acutely destabilized HF were followed at the Veteran Affairs Healthcare System in San Diego, CA. Multiple cardiac-related parameters were measured including ST2, B-type natriuretic peptide (BNP), NT-proBNP, and blood urea nitrogen (BUN). Plasma samples were collected at 6 time points between admission and discharge. Biomarker concentrations were correlated to survival at 90 days. Uni- and multivariate analyses were used to identify prognostic variables. From admission to discharge, percent change in ST2 was strongly predictive of 90-day mortality: those patients whose ST2 values decreased by 15.5% or more during the study period had a 7% chance of death, whereas patients whose ST2 levels failed to decrease by 15.5% in this time interval had a 33% chance of dying.


CONCLUSIONS
Percent change in ST2 concentrations during acute HF treatment is predictive of 90-day mortality and was independent of BNP or NT-proBNP levels. ST2 may provide clinicians with an additional tool for guiding treatment in patients with acute destabilized HF.
Boisot
Saskia
S
University of California at San Diego, Veteran Affairs San Diego Healthcare System, San Diego, CA 92161, USA.
Beede
Jennifer
J
Isakson
Susan
S
Chiu
Albert
A
Clopton
Paul
P
Januzzi
James
J
Maisel
Alan S
AS
Fitzgerald
Robert L
RL
D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality*; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D011956:Receptors, Cell Surface / Q000097:blood*; D015996:Survival Rate / Q000639:trends
D015415:Biomarkers; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D010446:Peptide Fragments; D011498:Protein Precursors; D011956:Receptors, Cell Surface; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain