Heart failure & cardiomyopathies
Association of Point-of-Care Testing for sST2 with Clinical Outcomes in Patients Hospitalized with Heart Failure
Main finding · Primary endpoint event, per log (unit) increase in sST2Result — go to the resultAdjusted hazard ratio 1.20 95% CI 1.09–1.32Authors' conclusion
Baseline sST2 remained an independent predictor of adverse events after adjusting for other predictors including NT-proBNP and hs-cTnT, particularly in patients with chronic decompensated heart failure and NYHA functional class I-II. And in the basis of baseline NT-proBNP and hs-cTnT, adding baseline sST2 could provide additional prognostic value for patients hospitalized with heart failure.
Study context
- Population
- Patients hospitalized with HF, July 2015 to December 2021
- Participants
- 1,726 consecutive patients
- Exposure
- Baseline sST2 as predictor of outcomes
- Outcome
- Composite of:
- All-cause death
- Heart transplantation
- LV assist device
- Follow-up
- Median 682 days
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Adjusted hazard ratio
1.20
95% CI 1.09–1.32
P < 0.001
Per log, as printed
- Primary endpoint events
- 434 patients (25.1%)
Observational data: associations, not effects.
Further findings
Primary endpoint, by HF type (subgroup)
| Adjusted HR (95% CI) | ||
|---|---|---|
| Baseline sST2Chronic decompensated HF | 1.19 (1.07–1.31) | |
| Baseline sST2Acute new onset HF | 1.28 (0.94–1.75) | |
| 0.512Adjusted hazard ratio (log scale) |
Primary endpoint, by New York Heart Association (NYHA) class (subgroup)
| Adjusted HR (95% CI) | ||
|---|---|---|
| Baseline sST2NYHA I-II | 1.67 (1.11–2.52) | |
| Baseline sST2NYHA III-IV | 1.18 (1.07–1.31) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
- Primary endpoint, by HF type (subgroup): P value for interaction <0.001
- Primary endpoint, by NYHA class (subgroup): P value for interaction <0.001
Prediction of primary endpoint at 1 month, 3 months, 1 year, 2 years
- AUC at 1 month
- 0.789
- AUC at 3 months
- 0.775
- AUC at 1 year
- 0.736
- AUC at 2 years
- 0.733
- Best cut-off at 1 month
- 27.2 ng/ml
- Best cut-off at 3 months
- 27.1 ng/ml
- Best cut-off at 1 year
- 27.1 ng/ml
- Best cut-off at 2 years
- 25.1 ng/ml
Added prognostic value of sST2 over NT-proBNP and high-sensitivity cardiac troponin T (hs-cTnT)
- sST2 provided additional prognostic value
- all P values <0.05
Primary endpoint by number of elevated biomarkers (NT-proBNP, hs-cTnT, sST2)
- Three elevated biomarkers: higher risk vs one or two
- all P values <0.05
Original publication
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