Alberto Aimo1, Giuseppe Vergaro2, Andrea Ripoli3, Antoni Bayes-Genis4, Domingo A Pascual Figal5, Rudolf A de Boer6, Johan Lassus7, Alexandre Mebazaa8, Etienne Gayat8, Tobias Breidthardt9, Zaid Sabti9, Christian Mueller9, Hans-Peter Brunner-La Rocca10, W H Wilson Tang11, Justin L Grodin12, Yuhui Zhang13, Paulo Bettencourt14, Alan S Maisel15, Claudio Passino2, James L Januzzi16, Michele Emdin2. 1. Scuola Superiore Sant'Anna, Pisa, Italy. Electronic address: albertoaimo@libero.it. 2. Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana G. Monasterio, Pisa, Italy. 3. Fondazione Toscana G. Monasterio, Pisa, Italy. 4. Hospital Universitari Germans Trias i Pujol, Barcelona, Spain. 5. Hospital Universitario Arrixaca, University of Murcia, Murcia, Spain. 6. University Medical Center Groningen, Groningen, the Netherlands. 7. Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland. 8. INSERM U 942, Université Paris Diderot, APHP Hôpitaux Universitaires Saint Louis Lariboisière, Paris, France. 9. Universitätsspital Basel, Basel, Switzerland. 10. Department of Cardiology, Maastricht University Medical Centre, Maastricht, the Netherlands. 11. Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. 12. Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas. 13. Peking Union Medical College, Beijing, China. 14. University of Porto Medical School, Porto, Portugal. 15. University of California, San Diego, School of Medicine, San Diego, California. 16. Massachusetts General Hospital and Harvard Clinical Research Institute, Boston, Massachusetts.
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 log2(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.
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 log2(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.
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