Prognostic utility of soluble ST2 biomarker in heart failure patients with reduced ejection fraction

Abstract

sST2 is a member of interleukin 1 receptor family biomarker and the concentration of its soluble isoform increases with cardiac stress leading to cardiac fibrosis. It has 2 isoforms the ligand forms sST2L and soluble form. In acute or chronic heart failure the soluble form is highly prognostic and predictive of mortality. It’s a prospective study of patients aged 45 to 90 with reduced ejection fraction and cardiomyopathy. Sample collected for day 1,5,30. There outcome assessed at day 30 and mortality on one year follow up. Total 79 patients studied, 57 LVF cases and 22 healthy controls. 50 males, 29 females, Cardiomyopathy 24 cases. Mean sST2 value 137.7829±89 (SD). At 30 days outcome and one year mortality with significant P value 0.000. As the age increases sST2 levels rises. For cardiomyopathy patients sST2 (141±78). At day 5 and 30 patients improved with decrease in levels where worsened patients had persistent high values. Those patient with more than 250 or implausible values had worse outcome or expired. Most important those responded to appropriate treatment values significantly improved. For cardiomyopathy patients values remained high persistently and ultimately required cardiac transplant or definitive line of treatment. sST2 is diagnostic and prognostic marker in patients with HFrEF presenting as acute or chronic heart failure. Significant p values for 30 days outcome and mortality. In cardiomyopathy patients with persistent high levels were bad prognostic indicator and suggests consideration of definitive line of treatment.