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V N Protasov1, O Yu Narusov, A A Skvortsov

  • 1FSBO National Medical research center of cardiology of the Ministry of healthcare of the Russian Federation. fake@neicon.ru.

Kardiologiia
|February 2, 2019
PubMed
Summary
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Elevated levels of soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-brain natriuretic peptide (NT-proBNP) upon hospital discharge predict adverse events in chronic heart failure (HF) patients. Measuring both biomarkers, or sST2 alone, aids in assessing long-term prognosis after HF decompensation.

Area of Science:

  • Cardiology
  • Biomarker Research
  • Heart Failure Management

Background:

  • Chronic heart failure (HF) decompensation poses a significant risk for adverse cardiovascular events.
  • Identifying reliable prognostic markers is crucial for optimizing patient management and outcomes.
  • Existing biomarkers may not fully capture the complex pathophysiology of HF decompensation.

Purpose of the Study:

  • To evaluate the prognostic value of various biomarkers and their combinations in patients who survived acute decompensation of chronic heart failure.
  • To identify the most effective biomarker or combination for predicting long-term adverse events.
  • To establish optimal cut-off values for key biomarkers at hospital discharge.

Main Methods:

  • A prospective, single-center study included 159 patients hospitalized for HF decompensation.

Related Experiment Videos

  • Measurements of NT-proBNP, hsTnT, copeptin, sST2, NGAL, and galectin-3 were performed at admission and discharge.
  • A combined endpoint included cardiovascular death, HF rehospitalization, HF deterioration requiring diuretics, and successful resuscitation.

    • Main Results:

    • During one-year follow-up, 35.2% of patients reached the combined primary endpoint.
    • ROC analysis showed significant predictive value for NT-proBNP, sST2, and copeptin at discharge.
    • Elevated levels of sST2 (≥37.8 hg/ml) and NT-proBNP (≥1696 rg/ml) at discharge were associated with a maximal 1-year risk of death.
    • A combination of three or more elevated markers significantly increased the risk of adverse events (OR = 6.6).

    Conclusions:

    • Patients with three or more elevated biomarkers (sST2, NT-proBNP, copeptin, hsTnT) at hospital discharge face a high risk of adverse events.
    • The combination of sST2 and NT-proBNP concentrations at discharge offers the greatest prognostic value.
    • Measuring sST2 and NT-proBNP at discharge is sufficient for determining long-term prognosis in HF decompensation.
    • Alternatively, sST2 alone provides a nearly equivalent, albeit slightly less accurate, prognostic assessment.