Circulating levels and prognostic value of soluble ST2 in heart failure are less influenced by age than N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T

被引：47

作者：

Aimo, Alberto ^{[1
]}

Januzzi, James L., Jr. ^{[2
,3
]}

Vergaro, Giuseppe ^{[1
,4
]}

Richards, A. Mark ^{[5
]}

Lam, Carolyn S. P. ^{[6
]}

Latini, Roberto ^{[7
]}

Anand, Inder S. ^{[8
,9
]}

Cohn, Jay N. ^{[8
]}

Ueland, Thor ^{[10
,11
,12
]}

Gullestad, Lars ^{[11
]}

Aukrust, Pal ^{[11
]}

Brunner-La Rocca, Hans-Peter ^{[13
]}

Bayes-Genis, Antoni ^{[14
,15
]}

Lupon, Josep ^{[14
,15
]}

de Boer, Rudolf A. ^{[16
]}

Takeishi, Yasuchika ^{[17
]}

Egstrup, Michael ^{[18
]}

Gustafsson, Ida ^{[18
]}

Gaggin, Hanna K. ^{[2
,3
]}

Eggers, Kai M. ^{[19
]}

Huber, Kurt ^{[20
,21
]}

Gamble, Greg D. ^{[22
]}

Ling, Lieng H. ^{[6
]}

Leong, Kui Tong Gerard ^{[23
]}

Yeo, Poh Shuah Daniel ^{[24
]}

Ong, Hean Yee ^{[25
]}

Jaufeerally, Fazlur ^{[26
]}

Ng, Tze P. ^{[6
]}

Troughton, Richard ^{[27
]}

Doughty, Robert N. ^{[22
]}

Passino, Claudio ^{[4
,5
]}

Emdin, Michele ^{[4
,5
]}

机构：

[1] Scuola Super Sant Anna, Pisa, Italy

[2] Massachusetts Gen Hosp, Boston, MA 02114 USA

[3] Baim Inst Clin Res, Boston, MA USA

[4] Fdn Toscana G Monasterio, Pisa, Italy

[5] Univ Otago, Dunedin, New Zealand

[6] Natl Univ Singapore, Singapore, Singapore

[7] IRCCS Ist Ric Farmacol Mario Negri, Milan, Italy

[8] Univ Minnesota, Minneapolis, MN USA

[9] VA Med Ctr, Minneapolis, MN USA

[10] Oslo Univ Hosp, Oslo, Norway

[11] Univ Oslo, Oslo, Norway

[12] Univ Tromso, Tromso, Norway

[13] Maastricht Univ, Med Ctr, Maastricht, Netherlands

[14] Hosp Badalona Germans Trias & Pujol, Badalona, Barcelona, Spain

[15] Inst Salud Carlos III, CIBER Cardiovasc, Madrid, Spain

[16] Univ Med Ctr Groningen, Groningen, Netherlands

[17] Fukushima Med Univ, Fukushima, Japan

[18] Copenhagen Univ Hosp, Rigshosp, Copenhagen, Denmark

[19] Uppsala Univ, Uppsala, Sweden

[20] Wilhelminenspital Stadt Wien, Vienna, Austria

[21] Sigmund Freud Univ, Med Sch, Vienna, Austria

[22] Univ Auckland, Auckland, New Zealand

[23] Changi Gen Hosp, Singapore, Singapore

[24] Tan Tock Seng Hosp, Singapore, Singapore

[25] Khoo Teck Puat Hosp, Singapore, Singapore

[26] Singapore Gen Hosp, Singapore, Singapore

[27] Univ Otago, Christchurch, New Zealand

来源：

EUROPEAN JOURNAL OF HEART FAILURE | 2020年 / 22卷 / 11期

基金：

英国医学研究理事会;

关键词：

sST2; Biomarkers; Age; Prognosis; Heart failure; RENAL-FUNCTION; SST2; EPIDEMIOLOGY; BIOLOGY; SEX;

D O I：

10.1002/ejhf.1701

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin T (hs-TnT) and soluble suppression of tumorigenesis-2 (sST2) predict outcome in chronic heart failure (HF). We assessed the influence of age on circulating levels and prognostic significance of these biomarkers. Methods and results Individual data from 5301 patients with chronic HF and NT-proBNP, hs-TnT, and sST2 data were evaluated. Patients were stratified according to age: <60 years (n = 1332, 25%), 60-69 years (n = 1628, 31%), 70-79 years (n = 1662, 31%), and >= 80 years (n = 679, 13%). Patients (median age 66 years, 75% men, median left ventricular ejection fraction 28%, 64% with ischaemic HF) had median NT-proBNP 1564 ng/L, hs-TnT 21 ng/L, and sST2 29 ng/mL. Age independently predicted NT-proBNP and hs-TnT, but not sST2. The best NT-proBNP and hs-TnT cut-offs for 1-year and 5-year all-cause and cardiovascular mortality and 1- to 12-month HF hospitalization increased with age, while the best sST2 cut-offs did not. When stratifying patients according to age- and outcome-specific cut-offs, this stratification yielded independent prognostic significance over NT-proBNP levels only, or the composite of NT-proBNP and hs-TnT, and improved risk prediction for most endpoints. Finally, absolute NT-proBNP, hs-TnT, and sST2 levels predicted outcomes independent of age, sex, left ventricular ejection fraction category, ethnic group, and other variables. Conclusions Soluble ST2 is less influenced by age than NT-proBNP or hs-TnT; all these biomarkers predict outcome regardless of age. The use of age- and outcome-specific cut-offs of NT-proBNP, hs-TnT and sST2 allows more accurate risk stratification than NT-proBNP alone or the combination of NT-proBNP and hs-TnT.

引用

页码：2078 / 2088

页数：11

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