Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator
Background. Heart failure (HF) is the terminal stage of all cardiovascular events. Although implantable cardioverter defibrillator (ICD) therapies have reduced mortality among the high-risk HF population, it is necessary to determine whether certain factors can predict mortality even after cardiac d...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/4375651 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832566482866798592 |
|---|---|
| author | Zhi-wei Hou Hai-bo Yu Yan-chun Liang Yang Gao Guo-qing Xu Min Wu Zhu Mei Zu-lu Wang Zhi-guo Li Yu-ying Li Hai-xu Song Jia-yin Li Ya-ling Han |
| author_facet | Zhi-wei Hou Hai-bo Yu Yan-chun Liang Yang Gao Guo-qing Xu Min Wu Zhu Mei Zu-lu Wang Zhi-guo Li Yu-ying Li Hai-xu Song Jia-yin Li Ya-ling Han |
| author_sort | Zhi-wei Hou |
| collection | DOAJ |
| description | Background. Heart failure (HF) is the terminal stage of all cardiovascular events. Although implantable cardioverter defibrillator (ICD) therapies have reduced mortality among the high-risk HF population, it is necessary to determine whether certain factors can predict mortality even after cardiac device implantation. Growth stimulation expressed gene 2 (ST2) is an emerging biomarker for HF patient stratification in different clinical settings. Aims. This study aimed to investigate the relationship between baseline soluble ST2 (sST2) levels in serum and the clinical outcomes of high-risk HF patients with device implantation. Methods. Between January 2017 and August 2018, we prospectively recruited consecutive patients implanted with an ICD for heart failure, with LVEF ≤35% as recommended, and analyzed the basic characteristics, baseline serum sST2, and NT-proBNP levels, with at least 1-year follow-up. All-cause mortality was the primary endpoint. Results. During a 643-day follow-up, all-cause mortality occurred in 16 of 150 patients (10.67%). Incidence of all-cause mortality increased significantly in patients with sST2 levels above 34.98846 ng/ml (16.00% vs. 5.33%, P=0.034). After adjusting the model (age, gender, device implantation, prevention of sudden death, LVEDD, LVEF, WBC and CLBBB, hsTNT, etiology, and eGFR) and the model combined with NT-proBNP, the risk of all-cause death was increased by 2.5% and 1.9%, respectively, per ng/ml of sST2. The best sST2 cutoff for predicting all-cause death was 43.42671 ng/ml (area under the curve: 0.72, sensitive: 0.69, and specificity: 0.69). Compared to patients with sST2 levels below 43.42671 ng/ml, the risk of all-cause mortality was higher in those with values above the threshold (5.1% vs. 21.2%, P=0.002). ST2 level ≥43.42671 ng/ml was an independent predictor of all-cause mortality (HR: 3.30 [95% CI 1.02–10.67]). Age (HR: 1.06 [95% CI: 1.01–1.12]) and increased NT-proBNP per 100 (HR: 1.02 [95% CI: 1.01–1.03]) were also associated with all-cause mortality in ICD patients. Conclusions. sST2 level was associated with risk of all-cause mortality, and a threshold of 43.43 ng/ml showed good distinguishing performance to predict all-cause mortality in patients with severe heart failure, recommended for ICD implantation. Patients with sST2 levels more than 43.42671 ng/ml even after ICD implantation should therefore be monitored carefully. |
| format | Article |
| id | doaj-art-688854154a1a4548a6b9cdc1714047b7 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-688854154a1a4548a6b9cdc1714047b72025-02-03T01:03:58ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/43756514375651Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter DefibrillatorZhi-wei Hou0Hai-bo Yu1Yan-chun Liang2Yang Gao3Guo-qing Xu4Min Wu5Zhu Mei6Zu-lu Wang7Zhi-guo Li8Yu-ying Li9Hai-xu Song10Jia-yin Li11Ya-ling Han12Department of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaDepartment of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang 110016, ChinaBackground. Heart failure (HF) is the terminal stage of all cardiovascular events. Although implantable cardioverter defibrillator (ICD) therapies have reduced mortality among the high-risk HF population, it is necessary to determine whether certain factors can predict mortality even after cardiac device implantation. Growth stimulation expressed gene 2 (ST2) is an emerging biomarker for HF patient stratification in different clinical settings. Aims. This study aimed to investigate the relationship between baseline soluble ST2 (sST2) levels in serum and the clinical outcomes of high-risk HF patients with device implantation. Methods. Between January 2017 and August 2018, we prospectively recruited consecutive patients implanted with an ICD for heart failure, with LVEF ≤35% as recommended, and analyzed the basic characteristics, baseline serum sST2, and NT-proBNP levels, with at least 1-year follow-up. All-cause mortality was the primary endpoint. Results. During a 643-day follow-up, all-cause mortality occurred in 16 of 150 patients (10.67%). Incidence of all-cause mortality increased significantly in patients with sST2 levels above 34.98846 ng/ml (16.00% vs. 5.33%, P=0.034). After adjusting the model (age, gender, device implantation, prevention of sudden death, LVEDD, LVEF, WBC and CLBBB, hsTNT, etiology, and eGFR) and the model combined with NT-proBNP, the risk of all-cause death was increased by 2.5% and 1.9%, respectively, per ng/ml of sST2. The best sST2 cutoff for predicting all-cause death was 43.42671 ng/ml (area under the curve: 0.72, sensitive: 0.69, and specificity: 0.69). Compared to patients with sST2 levels below 43.42671 ng/ml, the risk of all-cause mortality was higher in those with values above the threshold (5.1% vs. 21.2%, P=0.002). ST2 level ≥43.42671 ng/ml was an independent predictor of all-cause mortality (HR: 3.30 [95% CI 1.02–10.67]). Age (HR: 1.06 [95% CI: 1.01–1.12]) and increased NT-proBNP per 100 (HR: 1.02 [95% CI: 1.01–1.03]) were also associated with all-cause mortality in ICD patients. Conclusions. sST2 level was associated with risk of all-cause mortality, and a threshold of 43.43 ng/ml showed good distinguishing performance to predict all-cause mortality in patients with severe heart failure, recommended for ICD implantation. Patients with sST2 levels more than 43.42671 ng/ml even after ICD implantation should therefore be monitored carefully.http://dx.doi.org/10.1155/2020/4375651 |
| spellingShingle | Zhi-wei Hou Hai-bo Yu Yan-chun Liang Yang Gao Guo-qing Xu Min Wu Zhu Mei Zu-lu Wang Zhi-guo Li Yu-ying Li Hai-xu Song Jia-yin Li Ya-ling Han Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator Cardiology Research and Practice |
| title | Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator |
| title_full | Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator |
| title_fullStr | Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator |
| title_full_unstemmed | Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator |
| title_short | Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator |
| title_sort | circulating soluble st2 predicts all cause mortality in severe heart failure patients with an implantable cardioverter defibrillator |
| url | http://dx.doi.org/10.1155/2020/4375651 |
| work_keys_str_mv | AT zhiweihou circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT haiboyu circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT yanchunliang circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT yanggao circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT guoqingxu circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT minwu circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT zhumei circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT zuluwang circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT zhiguoli circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT yuyingli circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT haixusong circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT jiayinli circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator AT yalinghan circulatingsolublest2predictsallcausemortalityinsevereheartfailurepatientswithanimplantablecardioverterdefibrillator |