Serial Sampling of ST2 Predicts 90-Day Mortality Following Destabilized Heart Failure

Background: To prospectively determine the prognostic utility of serial sampling of the interleukin-1 receptor family member. ST2, for predicting 90-day mortality in patients with heart failure (HF) admitted to a Veteran Affairs Medical Center. Methods and Results: A total 150 patients hospitalized with acutely destabilized HE were followed at the Veteran Affairs Healthcare System in San Diego, CA. Multiple cardiac-related parameters were measured including ST2. B-type natriuretic peptide (BNP), NT-proBNP, and blood urea nitrogen (BUN). Plasma samples were collected ill 6 time points between admission and discharge. Biomarker concentrations were correlated to survival at 90 days. Uni- and multivariate analyses Were used to identify prognostic variables. Front admission to discharge, percent change in ST2 was strongly predictive of 90-day mortality: those patients whose ST2 values decreased by 15.5% or more during the study period had a 7% chance of death. whereas patients whose ST2 levels failed to decrease by 15.5% ill this time interval had a 33% chance of dying. Conclusions: Percent change in ST2 concentrations during acute HF treatment is predictive of 90-day mortality and wits independent of BNP or NT-proBNP levels. ST2 may provide clinicians with an additional 1001 for guiding treatment in patients With acute destabilized HE (J Cardiac Fail 2008:14:732-738)