Serial sampling of st2 predicts 90-day mortality following destabilized heart failure
Journal of Cardiac Failure Vol. 14 No. 9 2008 Serial Sampling of ST2 Predicts 90-Day Mortality Following Destabilized Heart Failure SASKIA BOISOT, MD,JENNIFER BEEDE, SUSAN ISAKSON, BS,ALBERT CHIU, BS,PAUL CLOPTON, JAMES JANUZZI, MD,ALAN S. MAISEL, AND ROBERT L. FITZGERALD, PhD, San Diego, California; Boston, Massachusetts Background: To prospectively determine the prognostic utility of serial sampling of the interleukin-1receptor family member, ST2, for predicting 90-day mortality in patients with heart failure (HF) admittedto a Veteran Affairs Medical Center.Methods and Results: A total 150 patients hospitalized with acutely destabilized HF were followed atthe Veteran Affairs Healthcare System in San Diego, CA. Multiple cardiac-related parameters were mea-sured 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 concentra-tions were correlated to survival at 90 days. Uni- and multivariate analyses were used to identify prognos-tic variables. From admission to discharge, percent change in ST2 was strongly predictive of 90-daymortality: those patients whose ST2 values decreased by 15.5% or more during the study period hada 7% chance of death, whereas patients whose ST2 levels failed to decrease by 15.5% in this time intervalhad a 33% chance of dying.Conclusions: Percent change in ST2 concentrations during acute HF treatment is predictive of 90-daymortality and was independent of BNP or NT-proBNP levels. ST2 may provide clinicians with an addi-tional tool for guiding treatment in patients with acute destabilized HF. (J Cardiac Fail 2008;14:732e738)Key Words: ST2, B-type natriuretic peptide, Pro-B-type natriuretic peptide, heart failure.