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Interleukin family member ST2 and mortality in acute dyspnoea.

Authors: Socrates, T  DeFilippi, C  Reichlin, T  Twerenbold, R  Breidhardt, T  Noveanu, M  Potocki, M  Reiter, M  Arenja, N  Heinisch, C  Meissner, J  Jaeger, C  Christenson, R  Mueller, C 
Citation: Socrates T, etal., J Intern Med. 2010 Nov;268(5):493-500. doi: 10.1111/j.1365-2796.2010.02263.x.
Pubmed: (View Article at PubMed) PMID:20804518
DOI: Full-text: DOI:10.1111/j.1365-2796.2010.02263.x

OBJECTIVES: The study objective was to investigate the prognostic utility and patient-specific characteristics of ST2 (suppression of tumorigenicity 2), assessed with a novel sensitive assay. BACKGROUND: Suppression of tumorigenicity 2 signalling has been shown to be associated with death in cardiac and pulmonary diseases. DESIGN/SUBJECTS: In an international multicentre cohort design, we prospectively enrolled 1091 patients presenting with acute dyspnoea to the emergency department (ED). ST2 was measured in a blinded fashion using a novel assay and compared to B-type natriuretic peptide (BNP) and NT-proBNP. The primary end-point was mortality within 30 days and 1 year. The prognostic value of ST2 was evaluated in comparison and in addition to BNP and NT-proBNP. RESULTS: Suppression of tumorigenicity 2 concentrations was higher amongst decedents than among survivors (median 85 vs. 43 U mL(1), P < 0.001) and also higher in patients with impaired left ventricular ejection fraction (LVEF) when compared with preserved LVEF (P < 0.001). In receiver operator characteristics analysis, the area under the curve (AUC) for ST2, BNP and NT-proBNP to predict 30-day and 1-year mortality were 0.76, 0.63 and 0.71, and 0.72, 0.71 and 0.73, respectively. The combinations of ST2 with BNP or NT-proBNP improved prediction of mortality provided by BNP or NT-proBNP alone. After multivariable adjustment, ST2 values above the median (50 U mL(1)) significantly predicted 1-year mortality (HR 2.3, P < 0.001). CONCLUSION: In patients presenting to the ED with acute dyspnoea, ST2 is a strong and independent predictor of 30-day and 1-year mortality and might improve risk stratification already provided by BNP or NT-proBNP.

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CRRD Object Information
CRRD ID: 5144224
Created: 2011-08-02
Species: All species
Last Modified: 2011-08-02
Status: ACTIVE



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RGD is funded by grant HL64541 from the National Heart, Lung, and Blood Institute on behalf of the NIH.