Binas David, Daniel Hanna, Richter Anette, Ruppert Volker, Schlüter Klaus-Dieter, Schieffer Bernhard, Pankuweit Sabine
Department of Internal Medicine and Cardiology, Philipps-University Marburg, Marburg, Germany.
Institute for Medical Biometry and Epidemiology, Philipps-University Marburg, Marburg, Germany.
Open Heart. 2018 Feb 26;5(1):e000750. doi: 10.1136/openhrt-2017-000750. eCollection 2018.
Several studies indicate a prognostic value of sST2 and galectin-3 in heart failure (HF). While previous studies focused on ischaemic cause of HF, we investigated the role of sST2 and galectin-3 in patients with non-ischaemic dilated cardiomyopathy (DCM).
sST2 and galectin-3 serum concentrations were measured in 262 subjects with DCM. Survival rates were determined for all-cause mortality (ACM) and cardiac mortality (CM).
In a univariate model, sST2 as a continuous variable was a predictor of ACM (HR 1.05; 95% CI 1.03 to 1.07, P<0.001) and CM (HR 1.03; 95% CI 1.00 to 1.06, P=0.040). In the subgroup of patients with inflammatory and/or viral DCM (DCMi⋎viral), the endpoints ACM (HR 1.10; 95% CI 1.05 to 1.17, P<0.001) and CM (HR 1.10; 95% CI 1.02 to 1.18, P=0.013) were significant. In the subgroup of patients with idiopathic DCM, the endpoint ACM (HR 1.04; 95% CI 1.01 to 1.07, P=0.019) was significant. In a multivariate model, the prognostic value of the sST2 main group remained intact for ACM (HR 1.04; 95% CI 1.02 to 1.07, P=0.003).Univariate and multivariate analysis of galectin-3 as continuous variable did not show any significant result. However, in a quartile model, intermediate values of galectin-3 were significantly associated with a lower event rate of ACM and CM.
The study revealed that sST2 predicts ACM and CM in patients with non-ischaemic HF and could be useful especially in patients with inflammatory background. Our findings that intermediate levels of galectin-3 allow for better prognosis were new and different to other investigations.
NCT03090425; Results.
多项研究表明可溶性生长刺激表达基因2蛋白（sST2）和半乳糖凝集素-3在心力衰竭（HF）中具有预后价值。既往研究主要关注HF的缺血性病因，我们调查了sST2和半乳糖凝集素-3在非缺血性扩张型心肌病（DCM）患者中的作用。
测定了262例DCM患者的sST2和半乳糖凝集素-3血清浓度。确定了全因死亡率（ACM）和心脏死亡率（CM）的生存率。
在单变量模型中，sST2作为连续变量是ACM（风险比[HR]1.05；95%置信区间[CI]1.03至1.07，P<0.001）和CM（HR 1.03；95%CI 1.00至1.06，P=0.040）的预测指标。在炎症性和/或病毒性DCM（DCMi⋎viral）患者亚组中，ACM（HR 1.10；95%CI 1.05至1.17，P<0.001）和CM（HR 1.10；95%CI 1.02至1.18，P=0.013）终点具有显著性。在特发性DCM患者亚组中，ACM终点（HR 1.04；95%CI 1.01至1.07，P=0.019）具有显著性。在多变量模型中，sST2主要组对ACM的预后价值仍然存在（HR 1.04；95%CI 1.02至1.07，P=0.003）。对半乳糖凝集素-3作为连续变量的单变量和多变量分析未显示任何显著结果。然而，在四分位数模型中，半乳糖凝集素-3的中间值与较低的ACM和CM事件发生率显著相关。
该研究表明，sST2可预测非缺血性HF患者的ACM和CM，尤其在有炎症背景的患者中可能有用。我们发现半乳糖凝集素-3的中间水平预示着较好的预后，这一发现是新的，与其他研究不同。
NCT03090425；结果
