OBJECTIVES: We investigated the association of sST2 with diagnostic and prognostic outcomes and assessed whether it aids B-natriuretic peptide (BNP) in diagnosing and predicting outcomes in emergency department (ED) patients with suspected AHFS. METHODS: We recruited patients who presented to the ED of 3 tertiary hospitals with signs or symptoms of AHFS and met modified Framingham criteria for AHFS. Outcome measures were a final diagnosis of AHFS and 5-and 30-day adverse events. RESULTS: In the 295 subjects with sST2 available, the median sST2 was 0.20 ng/ml (IQR=0.10, 0.34). Although unadjusted analyses indicated sST2 was significantly associated with the diagnosis of AHFS (p=0.02), this was not so in the adjusted analysis (p=0.33). Moderately low diagnostic utility was noted with an AUC of 0.62 (95% CI=0.56, 0.69). Similar sST2 test characteristics were seen when BNP was restricted between 100 and 500 pg/ml. While sST2 was associated with AHFS readmission at 30-days (p=0.04), in the adjusted analyses it was not associated with adverse events. CONCLUSION: In patients with signs or symptoms of AHFS, unadjusted analyses indicated that sST2 was significantly associated with the diagnosis of AHFS and with 30-day AHFS recidivism. However, the associations did not carry over to adjusted analyses, and sST2 did not add significant information with regard to explaining the diagnostic and prognostic variability of BNP.
OBJECTIVES: We investigated the association of sST2 with diagnostic and prognostic outcomes and assessed whether it aids B-natriuretic peptide (BNP) in diagnosing and predicting outcomes in emergency department (ED) patients with suspected AHFS. METHODS: We recruited patients who presented to the ED of 3 tertiary hospitals with signs or symptoms of AHFS and met modified Framingham criteria for AHFS. Outcome measures were a final diagnosis of AHFS and 5-and 30-day adverse events. RESULTS: In the 295 subjects with sST2 available, the median sST2 was 0.20 ng/ml (IQR=0.10, 0.34). Although unadjusted analyses indicated sST2 was significantly associated with the diagnosis of AHFS (p=0.02), this was not so in the adjusted analysis (p=0.33). Moderately low diagnostic utility was noted with an AUC of 0.62 (95% CI=0.56, 0.69). Similar sST2 test characteristics were seen when BNP was restricted between 100 and 500 pg/ml. While sST2 was associated with AHFS readmission at 30-days (p=0.04), in the adjusted analyses it was not associated with adverse events. CONCLUSION: In patients with signs or symptoms of AHFS, unadjusted analyses indicated that sST2 was significantly associated with the diagnosis of AHFS and with 30-day AHFS recidivism. However, the associations did not carry over to adjusted analyses, and sST2 did not add significant information with regard to explaining the diagnostic and prognostic variability of BNP.
Authors: Mihai Gheorghiade; Faiez Zannad; George Sopko; Liviu Klein; Ileana L Piña; Marvin A Konstam; Barry M Massie; Edmond Roland; Shari Targum; Sean P Collins; Gerasimos Filippatos; Luigi Tavazzi Journal: Circulation Date: 2005-12-20 Impact factor: 29.690
Authors: Saskia Boisot; Jennifer Beede; Susan Isakson; Albert Chiu; Paul Clopton; James Januzzi; Alan S Maisel; Robert L Fitzgerald Journal: J Card Fail Date: 2008-07-26 Impact factor: 5.712
Authors: Ellen O Weinberg; Masahisa Shimpo; Shelley Hurwitz; Shin-ichi Tominaga; Jean-Lucien Rouleau; Richard T Lee Journal: Circulation Date: 2003-02-11 Impact factor: 29.690
Authors: Alan Maisel; Christian Mueller; Kirkwood Adams; Stefan D Anker; Nadia Aspromonte; John G F Cleland; Alain Cohen-Solal; Ulf Dahlstrom; Anthony DeMaria; Salvatore Di Somma; Gerasimos S Filippatos; Gregg C Fonarow; Patrick Jourdain; Michel Komajda; Peter P Liu; Theresa McDonagh; Kenneth McDonald; Alexandre Mebazaa; Markku S Nieminen; W Frank Peacock; Marco Tubaro; Roberto Valle; Marc Vanderhyden; Clyde W Yancy; Faiez Zannad; Eugene Braunwald Journal: Eur J Heart Fail Date: 2008-08-29 Impact factor: 15.534
Authors: Devin M Parker; Allen D Everett; Meagan E Stabler; Luca Vricella; Marshall L Jacobs; Jeffrey P Jacobs; Heather Thiessen-Philbrook; Chirag R Parikh; Jeremiah R Brown Journal: J Card Surg Date: 2019-04-03 Impact factor: 1.620
Authors: Fernando Friões; Patrícia Lourenço; Olga Laszczynska; Pedro-Bernardo Almeida; João-Tiago Guimarães; James L Januzzi; Ana Azevedo; Paulo Bettencourt Journal: Clin Res Cardiol Date: 2015-01-14 Impact factor: 5.460