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Interleukin family member ST2 and mortality in acute dyspnoea

Date Issued
2010-01-01
Author(s)
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
Müller, C  
DOI
10.1111/j.1365-2796.2010.02263.x
Abstract
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.; Suppression of tumorigenicity 2 signalling has been shown to be associated with death in cardiac and pulmonary diseases.; 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.; 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).; 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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