title: Soluble ST2 predicts 1-year outcome in patients undergoing transcatheter aortic valve implantation.
abstract: BACKGROUND
  Soluble ST2 (sST2) has been introduced as a novel biomarker in patients suffering from heart failure for risk stratification. In this study, we sought to investigate whether sST2 is useful for risk stratification and prediction of mortality in patients undergoing transcatheter aortic valve implantation (TAVI).
  
  
  METHODS
  A total of 274 patients undergoing TAVI were included in this study (149 female; age 81 ± 1 years; EUROSCORE 25 ± 1; STS score 3·8 ± 0·2). Plasma samples were obtained preinterventional and analysed for sST2. Patients were followed up 1 month and 1 year after TAVI.
  
  
  RESULTS
  In a Cox regression analysis, sST2 plasma concentration was associated with increased mortality (changes per pg/mL sST2 concentration; HR 1·00006 95% (1·00004-1·00009); P < 0·001). A cut-off by means of the Youden Index was calculated (10 070·27 pg/mL), and patients were retrospectively divided into two cohorts, in those above (31·3%) and those below (68·7%) this value. These two groups were then compared regarding mortality both after 30 days and 1 year: whereas 1-month mortality did not differ (7·0% vs. 10·3%, OR 1·50 95% CI (0·60-3·79; P = 0·46)), patients with a sST2 concentration above the cut-off of 10 070·27 pg/mL showed a significantly worse outcome after 1 year (49·2% vs. 23·2%; OR 3·21 95% CI (1·70-6·04); P < 0·001). After correction for confounders in a multivariate Cox regression analysis, sST2 (1·0002 95% CI (1·0001-1·0003); P = 0·001) concentration remained associated with mortality.
  
  
  CONCLUSIONS
  sST2 levels were associated with 1-year mortality after TAVI. Based on these results, we assume that sST2 might help to identify patients at high risk for death in whom conservative treatment should be considered.
authors.affiliation: Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Wernly
authors.affiliation: Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Lichtenauer
authors.affiliation: Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Jirak
authors.affiliation: Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.
authors.forename: Sarah
authors.initials: S
authors.lastname: Eder
authors.affiliation: 1st Medical Department-Cardiology, General Hospital Linz, Johannes Kepler University School of Medicine, Linz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Reiter
authors.affiliation: 1st Medical Department-Cardiology, General Hospital Linz, Johannes Kepler University School of Medicine, Linz, Austria.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kammler
authors.affiliation: 1st Medical Department-Cardiology, General Hospital Linz, Johannes Kepler University School of Medicine, Linz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kypta
authors.affiliation: Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Jung
authors.affiliation: Clinic of Internal Medicine I, Department of Cardiology, Universitätsherzzentrum Thüringen, Friedrich Schiller University Jena, Jena, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Franz
authors.affiliation: Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.
authors.forename: Uta C
authors.initials: UC
authors.lastname: Hoppe
authors.affiliation: Klinik für Kardiologie, Charite - Universitätsmedizin Berlin, Berlin, Deutschland.|Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Berlin, Berlin, Deutschland.
authors.forename: Ulf
authors.initials: U
authors.lastname: Landmesser
authors.affiliation: Clinic of Internal Medicine I, Department of Cardiology, Universitätsherzzentrum Thüringen, Friedrich Schiller University Jena, Jena, Germany.
authors.forename: Hans-Reiner
authors.initials: HR
authors.lastname: Figulla
authors.affiliation: Klinik für Kardiologie, Charite - Universitätsmedizin Berlin, Berlin, Deutschland.|Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Berlin, Berlin, Deutschland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lauten
mesh_terms: D001024:Aortic Valve Stenosis / Q000097:blood / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein / Q000378:metabolism*; D008297:Male; D013318:Stroke Volume / Q000502:physiology; D065467:Transcatheter Aortic Valve Replacement / Q000401:mortality*; D016896:Treatment Outcome
chemical_list: C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein
keywords: Aortic stenosis; ST2; biomarker; outcome; transcatheter aortic valve implantation