Measurement of the interleukin family member ST2 in patients with acute dyspnea: results from the PRIDE (Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department) study.

نویسندگان

  • James L Januzzi
  • W Frank Peacock
  • Alan S Maisel
  • Claudia U Chae
  • Robert L Jesse
  • Aaron L Baggish
  • Michelle O'Donoghue
  • Rahul Sakhuja
  • Annabel A Chen
  • Roland R J van Kimmenade
  • Kent B Lewandrowski
  • Donald M Lloyd-Jones
  • Alan H B Wu
چکیده

OBJECTIVES The aim of this study was to examine the value of measurement of the interleukin-1 receptor family member ST2 in patients with dyspnea. BACKGROUND Concentrations of ST2 have been reported to be elevated in patients with heart failure (HF). METHODS Five hundred ninety-three dyspneic patients with and without acute destabilized HF presenting to an urban emergency department were evaluated with measurements of ST2 concentrations. Independent predictors of death at 1 year were identified. 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 > or =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. CONCLUSIONS Among dyspneic patients with and without acute HF, ST2 concentrations are strongly predictive of mortality at 1 year and might be useful for prognostication when used alone or together with NT-proBNP.

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

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عنوان ژورنال:
  • Journal of the American College of Cardiology

دوره 50 7  شماره 

صفحات  -

تاریخ انتشار 2007