Format

Send to

Choose Destination
Heart. 2014 Nov;100(21):1715-21. doi: 10.1136/heartjnl-2014-305968. Epub 2014 Jul 30.

ST2 may not be a useful predictor for incident cardiovascular events, heart failure and mortality.

Author information

1
Department of General and Interventional Cardiology, Hamburg University Heart Center, Hamburg, Germany German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lübeck/Kiel, Germany Centre of Excellence for Public Health Northern Ireland, Queens University Belfast, Belfast, UK MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
2
Department of General and Interventional Cardiology, Hamburg University Heart Center, Hamburg, Germany German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lübeck/Kiel, Germany.
3
Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
4
Centre of Excellence for Public Health Northern Ireland, Queens University Belfast, Belfast, UK.

Abstract

OBJECTIVES:

We hypothesised that soluble ST2 (sST2) levels can identify people with elevated risk of subsequent cardiovascular disease (CVD) and add to existing risk prediction algorithms.

BACKGROUND:

ST2 is a receptor for the inflammatory cytokine IL33. Increased sST2 levels have been associated with heart failure and death in acute myocardial infarction patients and in the general population.

METHODS:

We measured high-sensitivity sST2 in 8444 men and women (25-74 years) from the FINRISK97 prospective population cohort. Cox proportional hazards modelling evaluated the ability of sST2 to predict fatal and non-fatal heart failure, CVD (coronary heart disease, stroke), diabetes, and death over 15 years follow-up. Discrimination and reclassification statistics for 10-year absolute risks compared the ability of sST2 to improve upon Framingham risk factors (FRF), N-terminal pro-brain natriuretic peptide (NT-proBNP), renal function (eGFR) and prevalent valvular heart disease (VHD).

RESULTS:

sST2 showed suggestive but non-significant associations with heart failure {(HR per 1 SD of log sST2 1.06; 95% CI 0.96 to 1.17 (562 events))}, and with CVD (1.01 95% CI 0.94 to 1.08) (914 events) after adjustment for FRF, NT-proBNP, eGFR and VHD. sST2 significantly predicted death from all causes following similar adjustment ({HR 1.09 (95% CI 1.01 to 1.19) (974 events))}. No improvement in the c-index was observed for models adding sST2 to the risk factors.

CONCLUSIONS:

In a healthy general population from Finland, sST2 did not improve long-term prediction of cardiovascular events including heart failure or all-cause mortality.

KEYWORDS:

CORONARY ARTERY DISEASE; HEART FAILURE

PMID:
25080471
DOI:
10.1136/heartjnl-2014-305968
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center