title: Biologic Variability of Soluble ST2 in Patients With Stable Chronic Heart Failure and Implications for Monitoring.
abstract: Soluble ST2 (sST2) is a novel biomarker implicated in myocardial remodeling and fibrosis. Recent studies in normal subjects have suggested that the biologic variability (BV) of sST2 is significantly lower than that of the B-type natriuretic peptides and N-terminal pro B-type natriuretic peptide (NTproBNP). It may, consequently, be a better biomarker for monitoring patients with chronic heart failure (CHF). To date, no published studies have examined the BV of sST2 in a heart failure population. Blood samples from 50 outpatients with pharmacologically optimized stable CHF and persistent left ventricular dysfunction (ejection fraction <40%) were collected at baseline, 1 hour, 1 month, 3 months, and 6 months. Using log-transformed data, mean intra-individual coefficients of variation (CVI) and subsequent reference change values were calculated for both NTproBNP and sST2. Results demonstrate significantly lower CVI and reference change values for sST2 compared with NTproBNP at 1 month (12.02 [36%] vs 36.75 [103%]), p <0.001, 3 months (12.23 [36%] vs 40.98 [114%]), p <0.001, and 6 months (16.41 [47%] vs 46.02 [128%]), p <0.001. In conclusion, the BV of sST2 is significantly lower than that of NTproBNP in patients with CHF. These results support previous indications that sST2 may be a better biomarker for monitoring such patients.
authors.affiliation: Department of Cardiovascular Research, King's College London, The James Black Centre, London, United Kingdom; Kings College Hospital NHS Foundation Trust, London, United Kingdom. Electronic address: susan.piper@kcl.ac.uk.
authors.forename: Susan
authors.initials: S
authors.lastname: Piper
authors.affiliation: Kings College Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Julia
authors.initials: J
authors.lastname: deCourcey
authors.affiliation: Kings College Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Roy
authors.initials: R
authors.lastname: Sherwood
authors.affiliation: Kings College Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: George
authors.initials: G
authors.lastname: Amin-Youssef
authors.affiliation: Department of Cardiovascular Research, King's College London, The James Black Centre, London, United Kingdom; Kings College Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Theresa
authors.initials: T
authors.lastname: McDonagh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D013318:Stroke Volume; D013997:Time Factors
chemical_list: D015415:Biomarkers; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain