Prognostic value of soluble ST2 in adults with congenital heart disease

Heart - Tập 105 Số 13 - Trang 999-1006 - 2019
Laurie W. Geenen1, Vivan J.M. Baggen1, Annemien E. van den Bosch1, Jannet A. Eindhoven1, Judith A.A.E. Cuypers1, Maarten Witsenburg1, Eric Boersma1, Jolien W. Roos‐Hesselink2
1Department of Cardiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
2Department of Cardiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam 3000 CA, The Netherlands

Tóm tắt

ObjectiveSoluble suppression of tumourigenicity-2 (sST2) is upregulated as response to myocardial stress and may be a potential biomarker for risk stratification in patients with adult congenital heart disease (ACHD). This study aimed to investigate the release of sST2 and its association with cardiovascular events in ACHD.MethodsIn this prospective cohort study, 602 consecutive patients with ACHD visiting the outpatient clinic were included (2011–2013). The association between sST2 and a primary composite endpoint of all-cause mortality, heart failure, hospitalisation, arrhythmia, thromboembolic events or cardiac interventions was investigated using multivariable Cox regression.ResultssST2 was measured in 590 (98%) patients (median age 33 [25–41] years, 42% women). After a median follow-up of 5.8 [IQR 5.1–6.2) years, 225 (38.5%) reached the primary endpoint. sST2 was significantly associated with the primary endpoint when adjusted for age, sex, creatinine and N  terminal pro-B type brain natriuretic peptide (NT-proBNP) (HR per twofold higher sST2: 1.28, 95% CI 1.03 to 1.58, p=0.025). This association negated when adjusted for clinical variables and NT-proBNP (HR per twofold higher sST2: 1.19, 95% CI 0.96 to 1.48, p=0.106). Stratified analysis in complex ACHD did show a significant association between sST2 and the primary endpoint when adjusted for clinical variables and NT-proBNP (HR per twofold higher sST2: 1.31, 95% CI 1.01 to 1.69, p=0.043). Sex-specific analysis showed an association between sST2 and the primary endpoint in women (HR per twofold higher sST2 1.80, 95% CI 1.30 to 2.49, p<0.001) but not in men (HR per twofold higher sST2 1.19, 95% CI 0.90 to 1.56, p=0.223).ConclusionssST2 is a promising novel biomarker in patients with ACHD, specifically in complex ACHD and women. Future research is warranted to elucidate sex-specific and diagnosis-specific differences.

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Tài liệu tham khảo

10.1161/01.CIR.0000038705.69871.D9

10.1161/01.CIR.0000047274.66749.FE

Yu J , Oh PC , Kim M , et al . Improved early risk stratification of patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention using a combination of serum soluble ST2 and NT-proBNP. PLoS One 2017;12:e0182829.doi:10.1371/journal.pone.0182829

10.1016/j.amjmed.2017.02.034

10.1016/j.jchf.2016.09.010

10.1016/j.jchf.2016.12.016

Laqqan M , Schwaighofer C , Graeber S , et al . Predictive value of soluble ST2 in adolescent and adult patients with complex congenital heart disease. PLoS One 2018;13:e0202406.doi:10.1371/journal.pone.0202406

10.1093/eurheartj/eht257

10.1016/S0735-1097(01)01272-4

10.1161/CIRCULATIONAHA.116.023255

10.1016/j.jacc.2013.07.019

Menting, 2016, Normal myocardial strain values using 2D speckle tracking echocardiography in healthy adults aged 20 to 72 years, Echocardiography, 33, 1665, 10.1111/echo.13323

Solberg, 1987, International Federation of Clinical Chemistry (IFCC), Scientific Committee, Clinical Section, Expert Panel on Theory of Reference Values, and International Committee for Standardization in Haematology (ICSH), Standing Committee on Reference Values. Approved Recommendation (1986) on the theory of reference values. Part 1. The concept of reference values, J Clin Chem Clin Biochem, 25, 337

10.1016/j.jacc.2017.09.026

Schmid, 2017, ST2 predicts survival in patients undergoing transcatheter aortic valve implantation, Int J Cardiol, 244, 87, 10.1016/j.ijcard.2017.06.066

10.1016/j.immuni.2005.09.015

10.1016/j.amjcard.2015.01.034

10.1172/JCI30634

10.1016/j.amjcard.2015.01.035

10.1016/j.cca.2009.08.010

10.1373/clinchem.2012.192153

10.1016/j.cca.2010.07.014

10.1136/heartjnl-2014-305968

10.1161/CIRCULATIONAHA.112.129437

Dieplinger, 2011, Soluble ST2 is not independently associated with androgen and estrogen status in healthy males and females, Clin Chem Lab Med, 49, 1515, 10.1515/CCLM.2011.239

Baggen VJM , Baart SJ , van den Bosch AE , et al . Prognostic Value of Serial N-Terminal Pro-B-Type Natriuretic Peptide Measurements in Adults With Congenital Heart Disease. J Am Heart Assoc 2018;7.doi:10.1161/JAHA.117.008349

10.1016/j.ahj.2013.02.029

10.1016/j.clinbiochem.2010.05.019

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Heart

Tập 105 Số 13

999-1006

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