Soluble ST2 as a diagnostic and prognostic marker for acute heart failure syndromes

Queen Henry-Okafor, Sean P. Collins, Cathy A. Jenkins, Karen F. Miller, David J. Maron, Allen J. Naftilan, Neal Weintraub, Gregory J. Fermann, John McPherson, Santosh Menon, Douglas B. Sawyer, Alan B. Storrow

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objectives: We investigated the association of sST2 with diagnostic and prognostic outcomes and assessed whether it aids B-natriuretic peptide (BNP) in diagnosing and predicting outcomes in emergency department (ED) patients with suspected AHFS. Methods: We recruited patients who presented to the ED of 3 tertiary hospitals with signs or symptoms of AHFS and met modified Framingham criteria for AHFS. Outcome measures were a final diagnosis of AHFS and 5-and 30-day adverse events. Results: In the 295 subjects with sST2 available, the median sST2 was 0.20 ng/ml (IQR=0.10, 0.34). Although unadjusted analyses indicated sST2 was significantly associated with the diagnosis of AHFS (p=0.02), this was not so in the adjusted analysis (p=0.33). Moderately low diagnostic utility was noted with an AUC of 0.62 (95% CI=0.56, 0.69). Similar sST2 test characteristics were seen when BNP was restricted between 100 and 500 pg/ml. While sST2 was associated with AHFS readmission at 30-days (p=0.04), in the adjusted analyses it was not associated with adverse events. Conclusion: In patients with signs or symptoms of AHFS, unadjusted analyses indicated that sST2 was significantly associated with the diagnosis of AHFS and with 30-day AHFS recidivism. However, the associations did not carry over to adjusted analyses, and sST2 did not add significant information with regard to explaining the diagnostic and prognostic variability of BNP.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalOpen Biomarkers Journal
Volume5
Issue number1
DOIs
StatePublished - May 11 2012

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Natriuretic Peptides
Heart Failure
Signs and Symptoms
Hospital Emergency Service
Tertiary Care Centers
Area Under Curve
Outcome Assessment (Health Care)

Keywords

  • Acute heart failure
  • Diagnosis
  • Prognosis
  • Soluble ST2

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Henry-Okafor, Q., Collins, S. P., Jenkins, C. A., Miller, K. F., Maron, D. J., Naftilan, A. J., ... Storrow, A. B. (2012). Soluble ST2 as a diagnostic and prognostic marker for acute heart failure syndromes. Open Biomarkers Journal, 5(1), 1-8. https://doi.org/10.2174/1875318301205010001

Soluble ST2 as a diagnostic and prognostic marker for acute heart failure syndromes. / Henry-Okafor, Queen; Collins, Sean P.; Jenkins, Cathy A.; Miller, Karen F.; Maron, David J.; Naftilan, Allen J.; Weintraub, Neal; Fermann, Gregory J.; McPherson, John; Menon, Santosh; Sawyer, Douglas B.; Storrow, Alan B.

In: Open Biomarkers Journal, Vol. 5, No. 1, 11.05.2012, p. 1-8.

Research output: Contribution to journalArticle

Henry-Okafor, Q, Collins, SP, Jenkins, CA, Miller, KF, Maron, DJ, Naftilan, AJ, Weintraub, N, Fermann, GJ, McPherson, J, Menon, S, Sawyer, DB & Storrow, AB 2012, 'Soluble ST2 as a diagnostic and prognostic marker for acute heart failure syndromes', Open Biomarkers Journal, vol. 5, no. 1, pp. 1-8. https://doi.org/10.2174/1875318301205010001
Henry-Okafor Q, Collins SP, Jenkins CA, Miller KF, Maron DJ, Naftilan AJ et al. Soluble ST2 as a diagnostic and prognostic marker for acute heart failure syndromes. Open Biomarkers Journal. 2012 May 11;5(1):1-8. https://doi.org/10.2174/1875318301205010001
Henry-Okafor, Queen ; Collins, Sean P. ; Jenkins, Cathy A. ; Miller, Karen F. ; Maron, David J. ; Naftilan, Allen J. ; Weintraub, Neal ; Fermann, Gregory J. ; McPherson, John ; Menon, Santosh ; Sawyer, Douglas B. ; Storrow, Alan B. / Soluble ST2 as a diagnostic and prognostic marker for acute heart failure syndromes. In: Open Biomarkers Journal. 2012 ; Vol. 5, No. 1. pp. 1-8.
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abstract = "Objectives: We investigated the association of sST2 with diagnostic and prognostic outcomes and assessed whether it aids B-natriuretic peptide (BNP) in diagnosing and predicting outcomes in emergency department (ED) patients with suspected AHFS. Methods: We recruited patients who presented to the ED of 3 tertiary hospitals with signs or symptoms of AHFS and met modified Framingham criteria for AHFS. Outcome measures were a final diagnosis of AHFS and 5-and 30-day adverse events. Results: In the 295 subjects with sST2 available, the median sST2 was 0.20 ng/ml (IQR=0.10, 0.34). Although unadjusted analyses indicated sST2 was significantly associated with the diagnosis of AHFS (p=0.02), this was not so in the adjusted analysis (p=0.33). Moderately low diagnostic utility was noted with an AUC of 0.62 (95{\%} CI=0.56, 0.69). Similar sST2 test characteristics were seen when BNP was restricted between 100 and 500 pg/ml. While sST2 was associated with AHFS readmission at 30-days (p=0.04), in the adjusted analyses it was not associated with adverse events. Conclusion: In patients with signs or symptoms of AHFS, unadjusted analyses indicated that sST2 was significantly associated with the diagnosis of AHFS and with 30-day AHFS recidivism. However, the associations did not carry over to adjusted analyses, and sST2 did not add significant information with regard to explaining the diagnostic and prognostic variability of BNP.",
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AU - Collins, Sean P.

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AU - Maron, David J.

AU - Naftilan, Allen J.

AU - Weintraub, Neal

AU - Fermann, Gregory J.

AU - McPherson, John

AU - Menon, Santosh

AU - Sawyer, Douglas B.

AU - Storrow, Alan B.

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N2 - Objectives: We investigated the association of sST2 with diagnostic and prognostic outcomes and assessed whether it aids B-natriuretic peptide (BNP) in diagnosing and predicting outcomes in emergency department (ED) patients with suspected AHFS. Methods: We recruited patients who presented to the ED of 3 tertiary hospitals with signs or symptoms of AHFS and met modified Framingham criteria for AHFS. Outcome measures were a final diagnosis of AHFS and 5-and 30-day adverse events. Results: In the 295 subjects with sST2 available, the median sST2 was 0.20 ng/ml (IQR=0.10, 0.34). Although unadjusted analyses indicated sST2 was significantly associated with the diagnosis of AHFS (p=0.02), this was not so in the adjusted analysis (p=0.33). Moderately low diagnostic utility was noted with an AUC of 0.62 (95% CI=0.56, 0.69). Similar sST2 test characteristics were seen when BNP was restricted between 100 and 500 pg/ml. While sST2 was associated with AHFS readmission at 30-days (p=0.04), in the adjusted analyses it was not associated with adverse events. Conclusion: In patients with signs or symptoms of AHFS, unadjusted analyses indicated that sST2 was significantly associated with the diagnosis of AHFS and with 30-day AHFS recidivism. However, the associations did not carry over to adjusted analyses, and sST2 did not add significant information with regard to explaining the diagnostic and prognostic variability of BNP.

AB - Objectives: We investigated the association of sST2 with diagnostic and prognostic outcomes and assessed whether it aids B-natriuretic peptide (BNP) in diagnosing and predicting outcomes in emergency department (ED) patients with suspected AHFS. Methods: We recruited patients who presented to the ED of 3 tertiary hospitals with signs or symptoms of AHFS and met modified Framingham criteria for AHFS. Outcome measures were a final diagnosis of AHFS and 5-and 30-day adverse events. Results: In the 295 subjects with sST2 available, the median sST2 was 0.20 ng/ml (IQR=0.10, 0.34). Although unadjusted analyses indicated sST2 was significantly associated with the diagnosis of AHFS (p=0.02), this was not so in the adjusted analysis (p=0.33). Moderately low diagnostic utility was noted with an AUC of 0.62 (95% CI=0.56, 0.69). Similar sST2 test characteristics were seen when BNP was restricted between 100 and 500 pg/ml. While sST2 was associated with AHFS readmission at 30-days (p=0.04), in the adjusted analyses it was not associated with adverse events. Conclusion: In patients with signs or symptoms of AHFS, unadjusted analyses indicated that sST2 was significantly associated with the diagnosis of AHFS and with 30-day AHFS recidivism. However, the associations did not carry over to adjusted analyses, and sST2 did not add significant information with regard to explaining the diagnostic and prognostic variability of BNP.

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KW - Prognosis

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