Measurement of the Interleukin Family Member ST2 in Patients With Acute Dyspnea

Results Concentrations of ST2 were higher among those with acute HF compared with those without (0.50 vs. 0.15 ng/ ml; p 0.001), although amino-terminal pro-brain natriuretic peptide (NT-proBNP) was superior to ST2 for diagnosis of acute HF. Median concentrations of ST2 at presentation to the emergency department were higher among decedents than survivors at 1 year (1.08 vs. 0.18 ng/ml; p 0.001), and in multivariable analyses, an ST2 concentration 0.20 ng/ml strongly predicted death at 1 year in dyspneic patients as a whole (HR 5.6, 95% confidence interval [CI] 2.2 to 14.2; p 0.001) as well as those with acute HF (hazard ratio [HR] 9.3, 95% CI 1.3 to 17.8; p 0.03). This risk associated with an elevated ST2 in dyspneic patients with and without HF appeared early and was sustained at 1 year after presentation (log-rank p value 0.001). A multi-marker approach with both ST2 and NT-proBNP levels identified subjects with the highest risk for death.