Szczurek-Wasilewicz Wioletta, Jurkiewicz Michał, Skrzypek Michał, Romuk Ewa, Jóźwiak Jacek, Gąsior Mariusz, Szyguła-Jurkiewicz Bożena
2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland.
Department of Pharmacology, Faculty of Medicine, University of Opole, 45-040 Opole, Poland.
Int J Mol Sci. 2024 Dec 28;26(1):171. doi: 10.3390/ijms26010171.
Biomarkers are critical for heart failure (HF) management by facilitating risk stratification, therapeutic decision-making, and monitoring treatment response. This prospective, single-center study aimed to assess predictors of death during one-year follow-up in patients with end-stage HF, with particular emphasis on the soluble suppression of tumorigenicity 2/left ventricular mass index (sST2/LVMI) ratio, modified Model for End-stage Liver Disease (modMELD), and Model for End-stage Liver Disease excluding INR (MELD-XI). This study comprised 429 consecutive patients with end-stage HF hospitalized between 2018 and 2023. The median age was 56.0 (50.0-60.0) years; and 89.2% were male. During the follow-up, 134 (31.2%) patients died. The area under the receiver operating characteristics (ROC) curves showed good predictive powers of sST2/LVMI-MELDXI (AUC: 0.90 [CI: 0.87-0.93]; specificity 85% and sensitivity 80%) and sST2/LVMI-modMELD (AUC: 0.92 [95% CI: 0.90-0.95]; specificity 92%, sensitivity 81%) for assessment of one-year mortality. In conclusion: the sST2/LVMI-modMELD and sST2/LVMI-MELD-XI ratios are independently related to one-year mortality in the analyzed group of patients. The prognostic power of these new models is significantly better than their individual components. This single-center study comprised a relatively small group of patients, so the prognostic value of these new models cannot be generalized to the entire HF population. Considering the limitations of this analysis, further randomized trials with a large cohort are necessary to confirm the utility of the new prognostic models in HF patients.
生物标志物对于心力衰竭（HF）的管理至关重要，它有助于进行风险分层、治疗决策以及监测治疗反应。这项前瞻性单中心研究旨在评估终末期HF患者一年随访期间的死亡预测因素，特别关注可溶性肿瘤抑制因子2/左心室质量指数（sST2/LVMI）比值、改良终末期肝病模型（modMELD）以及不包括国际标准化比值（INR）的终末期肝病模型（MELD-XI）。本研究纳入了2018年至2023年间连续住院的429例终末期HF患者。中位年龄为56.0（50.0 - 60.0）岁；男性占89.2%。随访期间，134例（31.2%）患者死亡。受试者工作特征（ROC）曲线下面积显示，sST2/LVMI-MELDXI（AUC：0.90 [CI：0.87 - 0.93]；特异性85%，敏感性80%）和sST2/LVMI-modMELD（AUC：0.92 [95% CI：0.90 - 0.95]；特异性92%，敏感性81%）对评估一年死亡率具有良好的预测能力。总之：在分析的患者组中，sST2/LVMI-modMELD和sST2/LVMI-MELD-XI比值与一年死亡率独立相关。这些新模型的预后能力明显优于其各个组成部分。这项单中心研究纳入的患者群体相对较小，因此这些新模型的预后价值不能推广至整个HF人群。考虑到本分析的局限性，有必要进行进一步的大样本随机试验，以证实新预后模型在HF患者中的实用性。
