Bahuleyan C G, Alummoottil George Koshy, Abdullakutty Jabir, Lordson A Jinbert, Babu Shifas, Krishnakumar V V, Pillai Anand M, Abraham George, Dilip M N
Cardiovascular Centre, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India.
Department of Cardiology, Government Medical College, Thiruvananthapuram, Kerala, India.
Indian Heart J. 2018 Jul;70 Suppl 1(Suppl 1):S79-S84. doi: 10.1016/j.ihj.2017.09.010. Epub 2017 Sep 20.
To study the prognostic value of soluble Suppression of Tumorigenicity-2 (sST2) in heart failure patients with reduced ejection fraction (HFrEF).
In this prospective, observational, multicenter study, patients with heart failure (HF) and left ventricular ejection fraction (LVEF) <50% were included. Clinical evaluation and serum levels of sST2 were estimated at five time points during follow up. Study endpoint was the relationship of baseline and serial sST2 concentration in the blood to the composite endpoints of cardiac death and re-hospitalization for worsening of HF during one year follow up period.
A total of 141 patients were enrolled. The mean age was 60±10.4years. At baseline evaluation, 49.6% patients were in New York Heart Association (NYHA) class III and 36.2% in class IV. Adverse events were observed in 57 patients (40.4%); 25 (17.7%) were re-hospitalized due to worsening of HF and 32 (22.7%) died due to cardiac causes. The median value of baseline sST2 was 46.36ng/ml (IQR 31.30-78.38). sST2 concentration at baseline was significantly higher among patients with adverse events in comparison to patients without adverse events (p=<0.001). Receiver operating characteristic curve (ROC) for baseline sST2 concentration identified 49ng/ml as optimal cut-off value to predict cardiac death and re-hospitalization, with a sensitivity and specificity of 72% and 75%, respectively.
In patients with HFrEF, sST2 concentration at baseline as well as on serial testing was significantly correlated with cardiac death and re-hospitalization for worsening of HF.
研究可溶性肿瘤抑制因子2（sST2）对射血分数降低的心力衰竭（HFrEF）患者的预后价值。
在这项前瞻性、观察性、多中心研究中，纳入了心力衰竭（HF）且左心室射血分数（LVEF）<50%的患者。在随访期间的五个时间点对患者进行临床评估并测定血清sST2水平。研究终点是血液中基线和连续sST2浓度与一年随访期内心脏性死亡和因HF恶化再次住院的复合终点之间的关系。
共纳入141例患者。平均年龄为60±10.4岁。在基线评估时，49.6%的患者为纽约心脏协会（NYHA）Ⅲ级，36.2%为Ⅳ级。57例患者（40.4%）发生不良事件；25例（17.7%）因HF恶化再次住院，32例（22.7%）因心脏原因死亡。基线sST2的中位数为46.36ng/ml（四分位间距31.30 - 78.38）。与无不良事件的患者相比，发生不良事件的患者基线时sST2浓度显著更高（p =<0.001）。基线sST2浓度的受试者工作特征曲线（ROC）确定49ng/ml为预测心脏性死亡和再次住院的最佳临界值，敏感性和特异性分别为72%和75%。
在HFrEF患者中，基线以及连续检测时的sST2浓度与心脏性死亡和因HF恶化再次住院显著相关。
