The real-life value of ST2 monitoring during heart failure decompensation: impact on long-term readmission and mortality

Abstract

Context: Prognostic value of ST2 levels and dynamics has not been investigated in acute heart failure (AHF) using prospective real-life measurements.

Objective: The objective of this study is to investigate the prognostic value of ST2 in AHF.

Methods: ST2 levels were determined at admission (n = 182) and discharge (n = 85). Primary endpoint was the composite of all-cause death and HF rehospitalisation at one year.

Results: Discharge ST2 (HR 2.42 [95% CI 1.46–4], p = 0.001) and ΔST2 (HR 2.32 [95% CI 1.21–4.57], p = 0.01) but not admission ST2, remained independently prognostic for the primary endpoint after comprehensive multivariable adjustment. ST2 significantly improved prognosis stratification on top of clinical variables and NTproBNP.

Conclusions: Routine clinical use of discharge ST2 and ST2 dynamics provide independent prognostic information.

• Acute heart failure
• biomarkers
• outcomes
• ST2
• prognosis

Acknowledgements

The authors thank Beatriz González, Roser Cabanes, Margarita Rodríguez, for data collection and invaluable work in the HF Clinic, and Joan Vila (MSc) and Judit Peñafiel (BSc) from IMIM-Institut de Recerca Hospital del Mar (Barcelona) for their statistical support.

Declaration of interest

The authors also wish to acknowledge Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (FIS PI14/01682). Dr. A. Bayes-Genis and Dr. J. Lupón received lecture honoraria from Roche Diagnostics and from Critical Diagnostics. Dr. A. Bayes-Genis and Dr. J Lupón report relationships with Critical Diagnostics.