Premium
Soluble ST2 is associated with adverse outcome in patients with heart failure of ischaemic aetiology
Author(s) -
Broch Kaspar,
Ueland Thor,
Nymo Ståle H.,
Kjekshus John,
Hulthe Johannes,
Muntendam Pieter,
McMurray John J.,
Wikstrand John,
Cleland John G.,
Aukrust Pål,
Gullestad Lars
Publication year - 2012
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfs006
Subject(s) - medicine , heart failure , cardiology , ejection fraction , myocardial infarction , clinical endpoint , hazard ratio , rosuvastatin , stroke (engine) , natriuretic peptide , proportional hazards model , randomized controlled trial , confidence interval , mechanical engineering , engineering
Aims In patients with ischaemic heart failure (HF), myocardial dysfunction often progresses. Elevated levels of soluble ST2 (sST2) are associated with a poor prognosis, but an association between sST2 and worsening heart failure per se has not been established. We assessed the association between sST2 and cause‐specific outcome in 1449 patients enrolled in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA study). Methods and results Soluble ST2 was measured with a highly sensitive immunoassay in 1449 patients ≥60 years of age with left ventricular ejection fraction (LVEF) ≤40% due to ischaemic heart disease. By Cox regression analyses, we found sST2 to be associated with the primary endpoint, i.e. a composite of cadiovascular (CV) death, non‐fatal myocardial infarction, or stroke, as well as all pre‐defined secondary endpoints in the CORONA study, even after adjustment for baseline clinical variables. After adjustment for N‐terminal pro brain natriuretic peptide and C‐reactive protein, the association between sST2 and the primary endpoint was attenuated and no longer statistically significant. However, sST2 remained associated with death due to worsening HF, hospitalization due to worsening HF, and hospitalization due to any CV cause, even after full adjustment. Conclusions Soluble ST2 is associated with adverse outcomes in older patients with systolic, ischaemic HF. In particular, sST2 is independently associated with worsening HF.