title: Serial monitoring of soluble interleukin family member ST2 in patients with acutely decompensated heart failure.
abstract: OBJECTIVE
  To determine whether serial measures of the interleukin receptor family member soluble ST2 (sST2) provide additional prognostic information to baseline measures for long-term risk stratification of acutely decompensated heart failure (ADHF) patients.
  
  
  METHODS
  We prospectively enrolled 72 ADHF patients. Blood samples were collected to measure sST2 concentrations at presentation and on day 4 of hospitalization. All patients were clinically followed, and vital status was registered.
  
  
  RESULTS
  Between presentation and day 4, sST2 concentrations decreased from 62 ng/ml (interquartile range 38-105) to 44 ng/ml (interquartile range 26-72; p < 0.001). Both sST2 concentrations at presentation [hazard ratio (HR) 1.011, 95% confidence interval (CI) 1.005-1.016; p < 0.001] and on day 4 (HR 1.015, 95% CI 1.005-1.024; p = 0.003) were independent predictors of mortality. Patients with sST2 ≤ 76 ng/ml at presentation and ≤ 46 ng/ml on day 4 had the lowest mortality rates (3%), whereas those with both sST2 values above these cutoff points had the highest mortality (50%). C index and reclassification analyses demonstrated that the use of serial sST2 measures resulted in an improvement in the accuracy of mortality prediction.
  
  
  CONCLUSIONS
  Among ADHF patients, sST2 concentrations tend to decrease following initiation of treatment and are prognostic both at presentation and during hospitalization. Serial sampling of sST2 adds prognostic information and may provide a basis for enhanced clinical decision making.
authors: Department of Cardiology, University Hospital Virgen de la Arrixaca, Murcia, Spain. sergiosmf13@hotmail.com
authors: S
authors: S
authors: Manzano-Fernández
authors: J L
authors: JL
authors: Januzzi
authors: F J
authors: FJ
authors: Pastor-Pérez
authors: J C
authors: JC
authors: Bonaque-González
authors: M
authors: M
authors: Boronat-Garcia
authors: D A
authors: DA
authors: Pascual-Figal
authors: S
authors: S
authors: Montalban-Larrea
authors: M
authors: M
authors: Navarro-Peñalver
authors: J M
authors: JM
authors: Andreu-Cayuelas
authors: M
authors: M
authors: Valdés
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000401:mortality*; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D011956:Receptors, Cell Surface / Q000378:metabolism*; D018570:Risk Assessment
chemical_list: D015415:Biomarkers; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D011956:Receptors, Cell Surface