Soluble ST2 serum concentration and renal function in heart failure.

Area of Science:

• Cardiology
• Nephrology
• Biomarker Research

Background:

• Soluble ST2 (sST2) is a known prognostic marker in heart failure (HF).
• The relationship between sST2 serum concentration and renal function remains unclear.
• This study investigates sST2 in relation to renal function and its prognostic utility in HF patients with renal insufficiency.

Purpose of the Study:

• To evaluate the association between sST2 serum concentration and estimated glomerular filtration rate (eGFR) in heart failure patients.
• To compare the prognostic value of sST2 in heart failure patients with varying degrees of renal function, particularly those with renal insufficiency.
• To determine if sST2 improves risk prediction in heart failure patients with renal insufficiency.

Main Methods:

• 879 heart failure patients were categorized into three groups based on eGFR: ≥60, 30-59, and <30 mL/min/1.73 m(2).
• Serum concentrations of sST2, N-terminal pro-B-type natriuretic peptide, and high-sensitivity cardiac troponin T were measured.
• All-cause mortality was tracked over a median follow-up of 3.46 years.

Main Results:

• sST2, NT-proBNP, and hs-cTnT inversely correlated with eGFR, indicating higher levels with poorer renal function.
• Patients with eGFR <60 mL/min/1.73 m(2) had a higher mortality rate (45%) compared to those with eGFR ≥60 mL/min/1.73 m(2).
• A biomarker combination including sST2 demonstrated superior discrimination, calibration, and reclassification for predicting mortality in patients with renal insufficiency.

Conclusions:

• The prognostic performance of sST2 in heart failure patients is not significantly affected by renal function.
• sST2, when added to other biomarkers, significantly improves long-term mortality prediction in heart failure patients with renal insufficiency.
• The enhanced predictive value of sST2 was more pronounced in patients with renal insufficiency than in the overall cohort.