title: ST2 Predicts Mortality and Length of Stay in a Critically Ill Noncardiac Intensive Care Unit Population.
abstract: OBJECTIVE
  The biomarker suppression of tumorigenicity 2 (ST2) is a well-established clinical biomarker of cardiac strain and is frequently elevated in a variety of cardiac conditions. Here, we sought to evaluate the prognostic value of ST2 in critically ill medical intensive care unit (MICU) patients without primary cardiac illness.
  
  
  METHODS
  We measured ST2 and high-sensitivity troponin T (hsTnT) on plasma specimens collected on 441 patients following admission to a noncardiac MICU and evaluated the prognostic power of ST2 both alone and in multivariate models.
  
  
  RESULTS
  Of these critically ill patients, 96% exhibited ST2 concentrations above the reference interval. ST2 concentrations were highly predictive of intensive care unit and hospital length of stay, as well as in-hospital mortality, with high concentrations predicting a poor prognosis. Rates of in-hospital mortality were more than four times higher in patients with ST2 concentrations in the highest compared with the lowest quartile. In multivariate analysis, ST2 remained an important predictor of death after adjustment for age, hsTnT, and common diagnoses.
  
  
  CONCLUSIONS
  ST2 is increased and predictive of prognosis in critically ill patients without primary cardiac disease, suggesting that critically ill patients may often have unrecognized cardiac injury. Clinical decision support algorithms incorporating ST2 and hsTnT results may be useful in patient risk stratification.
authors: From the Department of Pathology and Divisions of Harvard Medical School, Boston, MA.
authors: Joseph W
authors: JW
authors: Rudolf
authors: From the Department of Pathology and Divisions of Harvard Medical School, Boston, MA.
authors: Elizabeth L
authors: EL
authors: Lewandrowski
authors: From the Department of Pathology and Divisions of Harvard Medical School, Boston, MA.
authors: Kent B
authors: KB
authors: Lewandrowski
authors: Harvard Medical School, Boston, MA. Cardiology and.
authors: James L
authors: JL
authors: Januzzi
authors: Harvard Medical School, Boston, MA. Pulmonary/Critical Care, Massachusetts General Hospital.
authors: Ednan K
authors: EK
authors: Bajwa
authors: From the Department of Pathology and Divisions of Harvard Medical School, Boston, MA. jmbaron@partners.org.
authors: Jason M
authors: JM
authors: Baron
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D000072179:Interleukin-1 Receptor-Like 1 Protein / Q000097:blood*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D020107:Troponin T
keywords: Cardiac biomarker; Clinical decision support; High-sensitivity troponin T; ST2; Suppression of tumorigenicity 2; hsTnT