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J Card Fail. 2008 Nov;14(9):732-8. doi: 10.1016/j.cardfail.2008.06.415. Epub 2008 Jul 26.

Serial sampling of ST2 predicts 90-day mortality following destabilized heart failure.

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University of California at San Diego, Veteran Affairs San Diego Healthcare System, San Diego, CA 92161, USA.



To prospectively determine the prognostic utility of serial sampling of the interleukin-1 receptor family member, ST2, for predicting 90-day mortality in patients with heart failure (HF) admitted to a Veteran Affairs Medical Center.


A total 150 patients hospitalized with acutely destabilized HF were followed at the Veteran Affairs Healthcare System in San Diego, CA. Multiple cardiac-related parameters were measured including ST2, B-type natriuretic peptide (BNP), NT-proBNP, and blood urea nitrogen (BUN). Plasma samples were collected at 6 time points between admission and discharge. Biomarker concentrations were correlated to survival at 90 days. Uni- and multivariate analyses were used to identify prognostic variables. From admission to discharge, percent change in ST2 was strongly predictive of 90-day mortality: those patients whose ST2 values decreased by 15.5% or more during the study period had a 7% chance of death, whereas patients whose ST2 levels failed to decrease by 15.5% in this time interval had a 33% chance of dying.


Percent change in ST2 concentrations during acute HF treatment is predictive of 90-day mortality and was independent of BNP or NT-proBNP levels. ST2 may provide clinicians with an additional tool for guiding treatment in patients with acute destabilized HF.

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