sST2 Predicts Outcome in Chronic Heart Failure Beyond NT−proBNP and High-Sensitivity Troponin T

Michele Emdin, Alberto Aimo, Giuseppe Vergaro, Antoni Bayes-Genis, Josep Lupón, Roberto Latini, Jennifer Meessen, Inder Anand, Jay N Cohn, Jørgen Gravning, Lars Gullestad, Kaspar Broch, Thor Ueland, Ståle H. Nymo, Hans Peter Brunner-La Rocca, Rudolf A. de Boer, Hanna K. Gaggin, Andrea Ripoli, Claudio Passino, James L. Januzzi

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Soluble suppression of tumorigenesis-2 (sST2) is a biomarker related to inflammation and fibrosis. Objectives: This study assessed the independent prognostic value of sST2 in chronic heart failure (HF). Methods: Individual patient data from studies that assessed sST2 for risk prediction in chronic HF, together with N-terminal pro−B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT), were retrieved. Results: A total of 4,268 patients were evaluated (median age 68 years, 75% males, 65% with ischemic HF, 87% with left ventricular ejection fraction [LVEF] <40%). NT-proBNP, hs-TnT, and sST2 were 1,360 ng/l (interquartile interval: 513 to 3,222 ng/l), 18 ng/l (interquartile interval: 9 to 33 ng/l), and 27 ng/l (interquartile interval: 20 to 39 ng/l), respectively. During a 2.4-year median follow-up, 1,319 patients (31%) experienced all-cause death (n = 932 [22%] for cardiovascular causes). Among the 4,118 patients (96%) with available data, 1,029 (24%) were hospitalized at least once for worsening HF over 2.2 years. The best sST2 cutoff for the prediction of all-cause and cardiovascular death and HF hospitalization was 28 ng/ml, with good performance at Kaplan-Meier analysis (log-rank: 117.6, 61.0, and 88.6, respectively; all p < 0.001). In a model that included age, sex, body mass index, ischemic etiology, LVEF, New York Heart Association functional class, glomerular filtration rate, HF medical therapy, NT-proBNP, and hs-TnT, the risk of all-cause death, cardiovascular death, and HF hospitalization increased by 26%, 25%, and 30%, respectively, per each doubling of sST2. sST2 retained its independent prognostic value across most population subgroups. Conclusions: sST2 yielded strong, independent predictive value for all-cause and cardiovascular mortality, and HF hospitalization in chronic HF, and deserves consideration to be part of a multimarker panel together with NT-proBNP and hs-TnT.

Original languageEnglish (US)
Pages (from-to)2309-2320
Number of pages12
JournalJournal of the American College of Cardiology
Volume72
Issue number19
DOIs
StatePublished - Nov 6 2018

Fingerprint

Troponin T
Carcinogenesis
Heart Failure
Natriuretic Peptides
Cause of Death
Hospitalization
Stroke Volume
pro-brain natriuretic peptide (1-76)
Kaplan-Meier Estimate
Glomerular Filtration Rate
Body Mass Index
Fibrosis
Biomarkers
Inflammation
Mortality

Keywords

  • NT-proBNP
  • heart failure
  • prognosis
  • sST2
  • troponin T

PubMed: MeSH publication types

  • Journal Article

Cite this

Emdin, M., Aimo, A., Vergaro, G., Bayes-Genis, A., Lupón, J., Latini, R., ... Januzzi, J. L. (2018). sST2 Predicts Outcome in Chronic Heart Failure Beyond NT−proBNP and High-Sensitivity Troponin T. Journal of the American College of Cardiology, 72(19), 2309-2320. https://doi.org/10.1016/j.jacc.2018.08.2165

sST2 Predicts Outcome in Chronic Heart Failure Beyond NT−proBNP and High-Sensitivity Troponin T. / Emdin, Michele; Aimo, Alberto; Vergaro, Giuseppe; Bayes-Genis, Antoni; Lupón, Josep; Latini, Roberto; Meessen, Jennifer; Anand, Inder; Cohn, Jay N; Gravning, Jørgen; Gullestad, Lars; Broch, Kaspar; Ueland, Thor; Nymo, Ståle H.; Brunner-La Rocca, Hans Peter; de Boer, Rudolf A.; Gaggin, Hanna K.; Ripoli, Andrea; Passino, Claudio; Januzzi, James L.

In: Journal of the American College of Cardiology, Vol. 72, No. 19, 06.11.2018, p. 2309-2320.

Research output: Contribution to journalArticle

Emdin, M, Aimo, A, Vergaro, G, Bayes-Genis, A, Lupón, J, Latini, R, Meessen, J, Anand, I, Cohn, JN, Gravning, J, Gullestad, L, Broch, K, Ueland, T, Nymo, SH, Brunner-La Rocca, HP, de Boer, RA, Gaggin, HK, Ripoli, A, Passino, C & Januzzi, JL 2018, 'sST2 Predicts Outcome in Chronic Heart Failure Beyond NT−proBNP and High-Sensitivity Troponin T', Journal of the American College of Cardiology, vol. 72, no. 19, pp. 2309-2320. https://doi.org/10.1016/j.jacc.2018.08.2165
Emdin, Michele ; Aimo, Alberto ; Vergaro, Giuseppe ; Bayes-Genis, Antoni ; Lupón, Josep ; Latini, Roberto ; Meessen, Jennifer ; Anand, Inder ; Cohn, Jay N ; Gravning, Jørgen ; Gullestad, Lars ; Broch, Kaspar ; Ueland, Thor ; Nymo, Ståle H. ; Brunner-La Rocca, Hans Peter ; de Boer, Rudolf A. ; Gaggin, Hanna K. ; Ripoli, Andrea ; Passino, Claudio ; Januzzi, James L. / sST2 Predicts Outcome in Chronic Heart Failure Beyond NT−proBNP and High-Sensitivity Troponin T. In: Journal of the American College of Cardiology. 2018 ; Vol. 72, No. 19. pp. 2309-2320.
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abstract = "Background: Soluble suppression of tumorigenesis-2 (sST2) is a biomarker related to inflammation and fibrosis. Objectives: This study assessed the independent prognostic value of sST2 in chronic heart failure (HF). Methods: Individual patient data from studies that assessed sST2 for risk prediction in chronic HF, together with N-terminal pro−B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT), were retrieved. Results: A total of 4,268 patients were evaluated (median age 68 years, 75{\%} males, 65{\%} with ischemic HF, 87{\%} with left ventricular ejection fraction [LVEF] <40{\%}). NT-proBNP, hs-TnT, and sST2 were 1,360 ng/l (interquartile interval: 513 to 3,222 ng/l), 18 ng/l (interquartile interval: 9 to 33 ng/l), and 27 ng/l (interquartile interval: 20 to 39 ng/l), respectively. During a 2.4-year median follow-up, 1,319 patients (31{\%}) experienced all-cause death (n = 932 [22{\%}] for cardiovascular causes). Among the 4,118 patients (96{\%}) with available data, 1,029 (24{\%}) were hospitalized at least once for worsening HF over 2.2 years. The best sST2 cutoff for the prediction of all-cause and cardiovascular death and HF hospitalization was 28 ng/ml, with good performance at Kaplan-Meier analysis (log-rank: 117.6, 61.0, and 88.6, respectively; all p < 0.001). In a model that included age, sex, body mass index, ischemic etiology, LVEF, New York Heart Association functional class, glomerular filtration rate, HF medical therapy, NT-proBNP, and hs-TnT, the risk of all-cause death, cardiovascular death, and HF hospitalization increased by 26{\%}, 25{\%}, and 30{\%}, respectively, per each doubling of sST2. sST2 retained its independent prognostic value across most population subgroups. Conclusions: sST2 yielded strong, independent predictive value for all-cause and cardiovascular mortality, and HF hospitalization in chronic HF, and deserves consideration to be part of a multimarker panel together with NT-proBNP and hs-TnT.",
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TY - JOUR

T1 - sST2 Predicts Outcome in Chronic Heart Failure Beyond NT−proBNP and High-Sensitivity Troponin T

AU - Emdin, Michele

AU - Aimo, Alberto

AU - Vergaro, Giuseppe

AU - Bayes-Genis, Antoni

AU - Lupón, Josep

AU - Latini, Roberto

AU - Meessen, Jennifer

AU - Anand, Inder

AU - Cohn, Jay N

AU - Gravning, Jørgen

AU - Gullestad, Lars

AU - Broch, Kaspar

AU - Ueland, Thor

AU - Nymo, Ståle H.

AU - Brunner-La Rocca, Hans Peter

AU - de Boer, Rudolf A.

AU - Gaggin, Hanna K.

AU - Ripoli, Andrea

AU - Passino, Claudio

AU - Januzzi, James L.

PY - 2018/11/6

Y1 - 2018/11/6

N2 - Background: Soluble suppression of tumorigenesis-2 (sST2) is a biomarker related to inflammation and fibrosis. Objectives: This study assessed the independent prognostic value of sST2 in chronic heart failure (HF). Methods: Individual patient data from studies that assessed sST2 for risk prediction in chronic HF, together with N-terminal pro−B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT), were retrieved. Results: A total of 4,268 patients were evaluated (median age 68 years, 75% males, 65% with ischemic HF, 87% with left ventricular ejection fraction [LVEF] <40%). NT-proBNP, hs-TnT, and sST2 were 1,360 ng/l (interquartile interval: 513 to 3,222 ng/l), 18 ng/l (interquartile interval: 9 to 33 ng/l), and 27 ng/l (interquartile interval: 20 to 39 ng/l), respectively. During a 2.4-year median follow-up, 1,319 patients (31%) experienced all-cause death (n = 932 [22%] for cardiovascular causes). Among the 4,118 patients (96%) with available data, 1,029 (24%) were hospitalized at least once for worsening HF over 2.2 years. The best sST2 cutoff for the prediction of all-cause and cardiovascular death and HF hospitalization was 28 ng/ml, with good performance at Kaplan-Meier analysis (log-rank: 117.6, 61.0, and 88.6, respectively; all p < 0.001). In a model that included age, sex, body mass index, ischemic etiology, LVEF, New York Heart Association functional class, glomerular filtration rate, HF medical therapy, NT-proBNP, and hs-TnT, the risk of all-cause death, cardiovascular death, and HF hospitalization increased by 26%, 25%, and 30%, respectively, per each doubling of sST2. sST2 retained its independent prognostic value across most population subgroups. Conclusions: sST2 yielded strong, independent predictive value for all-cause and cardiovascular mortality, and HF hospitalization in chronic HF, and deserves consideration to be part of a multimarker panel together with NT-proBNP and hs-TnT.

AB - Background: Soluble suppression of tumorigenesis-2 (sST2) is a biomarker related to inflammation and fibrosis. Objectives: This study assessed the independent prognostic value of sST2 in chronic heart failure (HF). Methods: Individual patient data from studies that assessed sST2 for risk prediction in chronic HF, together with N-terminal pro−B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT), were retrieved. Results: A total of 4,268 patients were evaluated (median age 68 years, 75% males, 65% with ischemic HF, 87% with left ventricular ejection fraction [LVEF] <40%). NT-proBNP, hs-TnT, and sST2 were 1,360 ng/l (interquartile interval: 513 to 3,222 ng/l), 18 ng/l (interquartile interval: 9 to 33 ng/l), and 27 ng/l (interquartile interval: 20 to 39 ng/l), respectively. During a 2.4-year median follow-up, 1,319 patients (31%) experienced all-cause death (n = 932 [22%] for cardiovascular causes). Among the 4,118 patients (96%) with available data, 1,029 (24%) were hospitalized at least once for worsening HF over 2.2 years. The best sST2 cutoff for the prediction of all-cause and cardiovascular death and HF hospitalization was 28 ng/ml, with good performance at Kaplan-Meier analysis (log-rank: 117.6, 61.0, and 88.6, respectively; all p < 0.001). In a model that included age, sex, body mass index, ischemic etiology, LVEF, New York Heart Association functional class, glomerular filtration rate, HF medical therapy, NT-proBNP, and hs-TnT, the risk of all-cause death, cardiovascular death, and HF hospitalization increased by 26%, 25%, and 30%, respectively, per each doubling of sST2. sST2 retained its independent prognostic value across most population subgroups. Conclusions: sST2 yielded strong, independent predictive value for all-cause and cardiovascular mortality, and HF hospitalization in chronic HF, and deserves consideration to be part of a multimarker panel together with NT-proBNP and hs-TnT.

KW - NT-proBNP

KW - heart failure

KW - prognosis

KW - sST2

KW - troponin T

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U2 - 10.1016/j.jacc.2018.08.2165

DO - 10.1016/j.jacc.2018.08.2165

M3 - Article

VL - 72

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EP - 2320

JO - Journal of the American College of Cardiology.

JF - Journal of the American College of Cardiology.

SN - 0735-1097

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