Soluble ST2 Serum Concentration and Renal Function in Heart Failure
Por:
Bayes-Genis, A, Zamora, E, de Antonio, M, Galan, A, Vila, J, Urrutia, A, Diez, C, Coll, R, Altimir, S and Lupon, L
Publicada:
1 nov 2013
Resumen:
Background: Soluble ST2 (sST2) provides important prognostic information in patients with heart failure (HF). How sST2 serum concentration is related to renal function is uncertain. We evaluated the association between sST2 and renal function and compared its prognostic value in HF patients with renal insufficiency.
Methods and Results: Patients (n = 879; median age 70.4 years; 71.8% men) were divided into 3 sub-groups according to estimated glomerular filtration rate (eGFR): >= 60 mL/min/1.73 m(2) (n = 337); 30-59 mL/min/1.73 m(2) (n = 352); and <30 mL/min/1.73 m(2) (n = 190). sST2 (rho = -0.16; P < .001), N-terminal pro B-type natriuretic peptide (rho = -0.40; P < .001), and high-sensitivity cardiac troponin T (rho = -0.47; P < .001) inversely correlated with eGFR. All-cause mortality was the primary end point. During a median follow-up of 3.46 years, 312 patients (35%) died, 246 of them from the subgroup of 542 patients with eGFR <60 mL/min/1.73 m(2) (45%). Biomarker combination including sST2 showed best discrimination, calibration, and reclassification metrics in renal insufficiency patients (net reclassification improvement 16.6 [95% confidence interval (CI) 8.1-25; P <.001]; integrated discrimination improvement 4.2 [95% CI 2.2-6.2; P < .001]). Improvement in reclassification was higher in these patients than in the total cohort.
Conclusions: The prognostic value of sST2 was not influenced by renal function. On top of other biomarkers, sST2 improved long-term prediction in patients with renal insufficiency even more than in the total cohort.
Filiaciones:
:
Hosp Badalona Germans Trias & Pujol, Heart Failure Unit, Badalona 08916, Barcelona, Spain
Autonomous Univ Barcelona, Dept Med, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Heart Failure Unit, Badalona 08916, Barcelona, Spain
Autonomous Univ Barcelona, Dept Med, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Heart Failure Unit, Badalona 08916, Barcelona, Spain
Autonomous Univ Barcelona, Dept Med, Barcelona, Spain
Galan, A:
Hosp Badalona Germans Trias & Pujol, Serv Biochem, Badalona 08916, Barcelona, Spain
Vila, J:
IMIM Hosp del Mar Res Inst, Inflammatory & Cardiovasc Dis Programme, Barcelona, Spain
CIBER Epidemiol & Publ Hlth, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Heart Failure Unit, Badalona 08916, Barcelona, Spain
Autonomous Univ Barcelona, Dept Med, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Heart Failure Unit, Badalona 08916, Barcelona, Spain
Coll, R:
Hosp Badalona Germans Trias & Pujol, Heart Failure Unit, Badalona 08916, Barcelona, Spain
Autonomous Univ Barcelona, Dept Med, Barcelona, Spain
Altimir, S:
Hosp Badalona Germans Trias & Pujol, Heart Failure Unit, Badalona 08916, Barcelona, Spain
Autonomous Univ Barcelona, Dept Med, Barcelona, Spain
Lupon, L:
Hosp Badalona Germans Trias & Pujol, Heart Failure Unit, Badalona 08916, Barcelona, Spain
Autonomous Univ Barcelona, Dept Med, Barcelona, Spain
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