[Soluble Suppression of Tumorogenicity 2 Increases Opportunities for Risk Stratification After Acute Heart Failure...

Area of Science:

• Cardiology
• Biomarker Research
• Heart Failure Management

Background:

• Acute decompensated heart failure (ADHF) poses significant challenges in risk stratification and long-term patient management.
• Identifying reliable biomarkers for predicting adverse cardiovascular events in ADHF patients is crucial for optimizing treatment strategies.

Purpose of the Study:

• To assess the prognostic value of soluble ST2-receptor (sST2) concentrations in risk stratifying patients with ADHF during long-term follow-up.
• To determine the predictive capacity of sST2 and NT-proBNP levels at hospital discharge for cardiovascular events.

Main Methods:

• A prospective study included 159 patients with ADHF (NYHA class III-IV).
• Blood samples were collected at admission, discharge, and 3, 6, and 12 months to measure NT-proBNP, sST2, and hsTnT.
• The primary endpoint included cardiovascular death, HF hospitalization, HF deterioration, and successful resuscitation after CV death.

Main Results:

• Elevated NT-proBNP, sST2, and hsTnT levels were observed at admission and discharge, with significant reductions post-treatment (p<0.0001).
• During 1-year follow-up, 35.2% of patients experienced cardiovascular events.
• At discharge, sST2 (AUC=0.768) and NT-proBNP (AUC=0.727) showed strong predictive capacity for 1-year cardiovascular events. sST2 levels above 37.8 ng/ml and NT-proBNP above 1696 pg/ml at discharge were associated with the highest risk (HR 6.755 and HR 4.41, respectively).

Conclusions:

• sST2 and NT-proBNP levels exceeding 37.8 ng/ml and 1696 pg/ml, respectively, at hospital discharge predict an adverse prognosis in ADHF patients.
• Serial monitoring and reduction of sST2 and NT-proBNP levels below these thresholds post-discharge are essential for improving long-term outcomes in ADHF.