sST2 augments the prognostic value of simplified risk stratification in patients with connective tissue disease-associated pulmonary arterial hypertension: a single-center retrospective study

Abstract

Abstract Background The simplified risk stratification tool from the 2018 WSPH has become widely accepted for evaluating the severity of conditions in patients with pulmonary arterial hypertension (PAH) and plays a crucial role in guiding treatment. In this study, we aimed to explore the value of soluble suppression of tumorigenicity 2 (sST2) in assessing the prognosis of connective tissue disease-associated PAH (CTD-PAH) patients based on simplified risk stratification. Methods Based on the inclusion and exclusion criteria, a total of 84 patients with CTD-PAH diagnosed by right heart catheterization were enrolled in this study. A retrospective chart review was completed to assess the clinical presentation and laboratory test results of the patients. The baseline risk stratification of all patients was assessed using the simplified risk stratification model proposed by the 2018 WSPH. The endpoint of the study was clinical worsening. Survival rates were evaluated using Kaplan‒Meier analysis, and differences between the groups were compared using the log-rank test. Results (1) Patients classified as intermediate or low risk demonstrated no difference in the event-free survival rate. (2) A sST2 concentration ≥ 35 ng/mL can predict the occurrence of clinical worsening events in low- and intermediate-risk patients. (3) The event-free survival rate was significantly lower in patients whose sST2 levels were maintained or increased to > 35 ng/mL within 1 year. Conclusion sST2 enhances the prognostic value of simplified risk stratification in patients with CTD-PAH, most notably in the intermediate-risk group. Furthermore, variations in sST2 levels may predict the clinical prognosis of this disease.