Meta-Analysis of Soluble Suppression of Tumorigenicity-2 and Prognosis in Acute Heart Failure

Alberto Aimo*, Giuseppe Vergaro, Andrea Ripoli, Antoni Bayes-Genis, Domingo A Pascual Figal, Rudolf A de Boer, Johan Lassus, Alexandre Mebazaa, Etienne Gayat, Tobias Breidthardt, Zaid Sabti, Christian Mueller, Hans-Peter Brunner-La Rocca, W H Wilson Tang, Justin L Grodin, Yuhui Zhang, Paulo Bettencourt, Alan S Maisel, Claudio Passino, James L JanuzziMichele Emdin

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

59 Citations (Scopus)

Abstract

OBJECTIVES The aim of this study was to perform a meta-analysis of currently available data regarding the prognostic significance of soluble suppression of tumorigenecity-2 (sST2) concentration in acute heart failure (AHF).

BACKGROUND Concentration of sST2 may have prognostic value in AHF. A comprehensive assessment of all available studies regarding sST2 in AHF is lacking.

METHODS Three databases (MEDLINE, Cochrane Library, and Scopus) were searched. Inclusion criteria were follow-up studies, papers published in English, enrollment of patients with AHF, and availability of median hazard ratios for all-cause death and other outcome measures, when available.

RESULTS Ten studies were included, with a global population of 4,835 patients and a median follow-up duration of 13.5 months. The following global hazard ratios calculated for log(2)(sST2) were admission sST2 and all-cause death, 2.46 (95% confidence interval [CI]: 1.80 to 3.37; p <0.001); discharge sST2 and all-cause death, 2.06 (95% CI: 1.37 to 3.11; p <0.001); admission sST2 and cardiovascular death, 2.29 (95% CI: 1.41 to 3.73; p <0.001); discharge sST2 and cardiovascular death, 2.20 (95% CI: 1.48 to 3.25; p <0.001); admission sST2 and heart failure (HF) hospitalization, 1.21 (95% CI: 0.96 to 1.52; p = 0.060); discharge sST2 and HF hospitalization, 1.54 (95% CI: 1.03 to 2.32; p = 0.007); admission sST2 and all-cause death or HF hospitalization, 1.74 (95% CI: 1.24 to 2.45; p <0.001); and discharge sST2 and all-cause death or HF hospitalization, 1.63 (95% CI: 1.14 to 2.33; p <0.001).

CONCLUSIONS Plasma sST2 has prognostic value with respect to all-cause and cardiovascular death as well as the composite outcome of all-cause death or HF hospitalization, with both admission and discharge values having prognostic efficacy. Discharge sST2, but not admission sST2, is predictive of HF rehospitalization during follow-up. (C) 2017 by the American College of Cardiology Foundation.

Original languageEnglish
Pages (from-to)287-296
Number of pages10
JournalJACC. Heart failure
Volume5
Issue number4
DOIs
Publication statusPublished - Apr-2017

Keywords

  • acute heart failure
  • meta-analysis
  • prognosis
  • sST2
  • INTENSIVE-CARE-UNIT
  • FAMILY-MEMBER ST2
  • ACUTE DYSPNEA
  • EJECTION FRACTION
  • MORTALITY
  • ASSOCIATION
  • BIOMARKERS
  • GUIDELINES
  • UTILITY
  • COHORT

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