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Clinical Chemistry 54: 752-756, 2008; 10.1373/clinchem.2007.096560
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(Clinical Chemistry. 2008;54:752-756.)
© 2008 American Association for Clinical Chemistry, Inc.

Brief Communications

Increased Plasma Concentrations of Soluble ST2 are Predictive for 1-Year Mortality in Patients with Acute Destabilized Heart Failure

Thomas Mueller1,a, Benjamin Dieplinger1, Alfons Gegenhuber2, Werner Poelz3, Richard Pacher4 and Meinhard Haltmayer1,5

1 Department of Laboratory Medicine, Konventhospital Barmherzige Brueder, Linz, Austria;2 Department of Internal Medicine, Krankenhaus Bad Ischl, Austria;3 Institute for Applied System Sciences and Statistics, University of Linz, Austria;4 Department of Cardiology, Medical University of Vienna, Austria;5 Paracelsus Private Medical University, Salzburg, Austria

aaddress correspondence to this author at: Department of Laboratory Medicine, Konventhospital Barmherzige Brueder, Seilerstaette 2-4, A-4020 Linz, Austria. Fax +43-732-7677-3799; e-mail thomas.mueller{at}bs-lab.at.


Abstract

Background: The soluble isoform of the interleukin-1 receptor family member ST2 (sST2) has been implicated in heart failure. The aim of the present study was to evaluate the capability of sST2 as a prognostic marker in patients with acute destabilized heart failure.

Methods: sST2 plasma concentrations were obtained in 137 patients with acute destabilized heart failure attending the emergency department of a tertiary care hospital. The endpoint was defined as all-cause mortality, and the study participants were followed up for 365 days.

Results: Of the 137 patients enrolled, 41 died and 96 survived during follow-up. At baseline the median sST2 plasma concentration was significantly higher in the patients who died than in those who survived (870 vs 342 ng/L, P <0.001). Kaplan-Meier curve analyses demonstrated that the risk ratios for mortality were 2.45 (95% CI, 0.88–6.31; P = 0.086) and 6.63 (95% CI, 2.55–10.89; P <0.001) in the second tercile (sST2, 300–700 ng/L; 11 deaths vs 34 survivors) and third tercile (sST2, >700 ng/L; 25 deaths vs 21 survivors) of sST2 plasma concentrations compared with the first tercile (sST2, ≤300 ng/L; 5 deaths vs 41 survivors). In multivariable Cox proportional-hazards regression analyses, an sST2 plasma concentration in the upper tercile was a strong and independent predictor of all-cause mortality.

Conclusions: Increased sST2 concentrations determined in plasma samples drawn from patients with acute destabilized heart failure at their initial presentation indicate increased risk of future mortality. Increased sST2 plasma concentrations are independently and strongly associated with one-year all-cause mortality in these patients.




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