心力衰竭失代偿期ST2监测的实际应用价值：对长期再入院率和死亡率的影响

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

作者信息

Llibre Cinta, Zamora Elisabet, Caballero Àngel, Lupón Josep, Ros Alba, Benito Nuria, de Antonio Marta, Galán Amparo, Domingo Mar, Bayes-Genis Antoni

机构信息

a Heart Failure Unit and Cardiology Service, Hospital Universitari Germans Trias I Pujol , Badalona , Spain .

b Department of Medicine , Autonomous University of Barcelona , Barcelona , Spain , and.

出版信息

Biomarkers. 2016;21(3):225-32. doi: 10.3109/1354750X.2015.1130747. Epub 2016 Jan 15.

DOI:10.3109/1354750X.2015.1130747

PMID:26767401

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.

摘要

背景

急性心力衰竭（AHF）中ST2水平及动态变化的预后价值尚未通过前瞻性实际测量进行研究。

目的

本研究旨在探讨ST2在AHF中的预后价值。

方法

在入院时（n = 182）和出院时（n = 85）测定ST2水平。主要终点是一年时全因死亡和心力衰竭再住院的复合终点。

结果

在进行全面的多变量调整后，出院时的ST2（风险比2.42 [95%置信区间1.46 - 4]，p = 0.001）和ΔST2（风险比2.32 [95%置信区间1.21 - 4.57]，p = 0.01）而非入院时的ST2，对主要终点仍具有独立的预后价值。ST2在临床变量和NTproBNP基础上显著改善了预后分层。