RESEARCH ARTICLE
Soluble ST2 as a Diagnostic and Prognostic Marker for Acute Heart Failure Syndromes
Queen Henry-Okafor1, Sean P. Collins1, Cathy A. Jenkins1, Karen F. Miller1, David J. Maron1, Allen J. Naftilan1, Neal Weintraub4, Gregory J. Fermann2, John McPherson1, Santosh Menon3, Douglas B. Sawyer1, Alan B. Storrow1, *
Article Information
Identifiers and Pagination:
Year: 2012Volume: 5
First Page: 1
Last Page: 8
Publisher ID: TOBIOMJ-5-1
DOI: 10.2174/1875318301205010001
Article History:
Received Date: 02/01/2012Revision Received Date: 05/03/2012
Acceptance Date: 10/03/2012
Electronic publication date: 20/4/2012
Collection year: 2012
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Objectives:
We investigated the association of sST2 with diagnostic and prognostic outcomes and assessed whether it aids B-natriuretic peptide (BNP) in diagnosing and predicting outcomes in emergency department (ED) patients with suspected AHFS.
Methods:
We recruited patients who presented to the ED of 3 tertiary hospitals with signs or symptoms of AHFS and met modified Framingham criteria for AHFS. Outcome measures were a final diagnosis of AHFS and 5-and 30-day adverse events.
Results:
In the 295 subjects with sST2 available, the median sST2 was 0.20 ng/ml (IQR=0.10, 0.34). Although unadjusted analyses indicated sST2 was significantly associated with the diagnosis of AHFS (p=0.02), this was not so in the adjusted analysis (p=0.33). Moderately low diagnostic utility was noted with an AUC of 0.62 (95% CI=0.56, 0.69). Similar sST2 test characteristics were seen when BNP was restricted between 100 and 500 pg/ml. While sST2 was associated with AHFS readmission at 30-days (p=0.04), in the adjusted analyses it was not associated with adverse events.
Conclusion:
In patients with signs or symptoms of AHFS, unadjusted analyses indicated that sST2 was significantly asso-ciated with the diagnosis of AHFS and with 30-day AHFS recidivism. However, the associations did not carry over to ad-justed analyses, and sST2 did not add significant information with regard to explaining the diagnostic and prognostic vari-ability of BNP.