Document Detail


Soluble ST2 for predicting sudden cardiac death in patients with chronic heart failure and left ventricular systolic dysfunction.
MedLine Citation:
PMID:  19942089     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We studied whether the measurement of the soluble form of ST2 (sST2), an interleukin-1 receptor family member, could identify heart failure (HF) patients at risk of sudden cardiac death (SCD). BACKGROUND: The prediction of SCD remains an important challenge in patients with mild-to-moderate chronic HF. Concentrations of sST2 have been found increased and related to worse long-term outcomes in patients with acute HF. Whether sST2 has a prognostic role in SCD is unknown. METHODS: A nested case-control study was performed on 36 cases of SCD and 63 control patients (matched for age, sex, and left ventricular ejection fraction) obtained from the MUSIC (MUerte S??bita en Insuficiencia Card??aca) registry, a 3-year multicenter registry of ambulatory HF patients (New York Heart Association functional class II to III, left ventricular ejection fraction < or =45%). Demographic, clinical, echocardiographic, electrical, and biochemical data were collected at enrollment. RESULTS: Concentrations of sST2 were greater among decedents (0.23 ng/ml [interquartile range 0.16 to 0.43 ng/ml] vs. 0.12 ng/ml [interquartile range 0.06 to 0.23 ng/ml], p = 0.001) and were predictive of experiencing SCD (+0.1 ng/ml, odds ratio: 1.39, 95% confidence interval: 1.09 to 1.78, p = 0.006). On the basis of a combined biomarker status, only 4% of patients experienced SCD for neither sST2 nor N-terminal pro-B-type natriuretic peptide (NT-proBNP) above receiver-operator characteristic-derived cut-off points (0.15 ng/ml and 2,000 ng/l, respectively), 34% for either biomarker above, and 71% for both biomarkers above (p < 0.001 for trend). This combined variable added incremental prognostic value to the multivariable regression model (p < 0.001). CONCLUSIONS: Elevated sST2 concentrations are predictive of SCD in patients with chronic HF and provide complementary information to NT-proBNP levels. A combined biomarker approach may have an impact on clinical decision-making.
Authors:
Domingo A Pascual-Figal; Jordi Ordo??ez-Llanos; Pedro L Tornel; Rafael V??zquez; Teresa Puig; Mariano Vald??s; Juan Cinca; Antoni Bayes de Luna; Antoni Bayes-Genis;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  54     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-27     Completed Date:  2010-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2174-9     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Service, Virgen de la Arrixaca Hospital and Department of Medicine, University of Murcia, Murcia 30120, Spain. dapascual@servicam.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Chronic Disease
Death, Sudden, Cardiac / etiology*
Enzyme-Linked Immunosorbent Assay
Female
Follow-Up Studies
Heart Failure / blood*,  complications
Humans
Male
Myocardial Contraction / physiology*
Prognosis
Receptors, Cell Surface / blood*
Receptors, Interleukin-1
Retrospective Studies
Systole
Ventricular Dysfunction, Left / blood*,  complications,  physiopathology
Chemical
Reg. No./Substance:
0/Biological Markers; 0/IL1RL1 protein, human; 0/Receptors, Cell Surface; 0/Receptors, Interleukin-1

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