Tse Gary, Ip Christina, Luk King Sum, Gong Mengqi, Ting Yan Yee, Lakhani Ishan, Bazoukis George, Li Guangping, Letsas Konstantinos P, Dong Mei, Liu Tong, Wong Martin C S
Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
Faculty of Medicine, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China.
Heart Asia. 2018 Mar 6;10(1):e010980. doi: 10.1136/heartasia-2017-010980. eCollection 2018.
Soluble suppression of tumorigenicity 2 (sST2) is a member of the interleukin-1 receptor family and a modulator of hypertrophic and fibrotic responses. Its prognostic value for patients undergoing aortic valve replacement (AVR) has been examined in prospective studies but to date, there has been no systematic evaluation or meta-analysis on this issue.
PubMed and Embase were searched until 1 October 2017 for studies that evaluated the relationship between sST2 levels and mortality after AVR.
A total of 18 and 37 entries were retrieved from both databases, from which four studies were included in the final meta-analysis. In a total of 1154 subjects (50% male, mean age 80±10 years old, mean follow-up 14 months), elevated sST2 levels were significantly associated with a 44% increase in the risk of all-cause mortality (HR 1.44, 95% CI 1.30 to 1.60, p<0.0001; I: 44%).
sST2 significantly predicts all-cause mortality in patients who have undergone AVR, but this conclusion is limited by the small number of patients. Larger prospective studies are required to better elucidate its value for risk stratification in this patient population.
可溶性肿瘤抑制因子2（sST2）是白细胞介素-1受体家族的成员，也是肥厚和纤维化反应的调节剂。前瞻性研究已探讨了其对接受主动脉瓣置换术（AVR）患者的预后价值，但迄今为止，尚未对此问题进行系统评价或荟萃分析。
检索截至2017年10月1日的PubMed和Embase数据库，查找评估sST2水平与AVR术后死亡率之间关系的研究。
两个数据库共检索到18篇和37篇文献，最终荟萃分析纳入了4项研究。总共1154名受试者（50%为男性，平均年龄80±10岁，平均随访14个月），sST2水平升高与全因死亡率风险显著增加44%相关（HR 1.44，95%CI 1.30至1.60，p<0.0001；I²：44%）。
sST2显著预测接受AVR患者的全因死亡率，但这一结论受患者数量较少的限制。需要更大规模的前瞻性研究，以更好地阐明其在该患者群体中进行风险分层的价值。
