ST2 may not be a useful predictor for incident cardiovascular events, heart failure and mortality
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ST2 may not be a useful predictor for incident cardiovascular events, heart failure and mortality. / Hughes, Maria F; Appelbaum, Sebastian; Havulinna, Aki S; Jagodzinski, Annika; Zeller, Tanja; Kee, Frank; Blankenberg, Stefan; Salomaa, Veikko; FINRISK and BiomarCaRE investigators.
In: HEART, Vol. 100, No. 21, 11.2014, p. 1715-1721.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - ST2 may not be a useful predictor for incident cardiovascular events, heart failure and mortality
AU - Hughes, Maria F
AU - Appelbaum, Sebastian
AU - Havulinna, Aki S
AU - Jagodzinski, Annika
AU - Zeller, Tanja
AU - Kee, Frank
AU - Blankenberg, Stefan
AU - Salomaa, Veikko
AU - FINRISK and BiomarCaRE investigators
N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
PY - 2014/11
Y1 - 2014/11
N2 - OBJECTIVES: We hypothesised that soluble ST2 (sST2) levels can identify people with elevated risk of subsequent cardiovascular disease (CVD) and add to existing risk prediction algorithms.BACKGROUND: ST2 is a receptor for the inflammatory cytokine IL33. Increased sST2 levels have been associated with heart failure and death in acute myocardial infarction patients and in the general population.METHODS: We measured high-sensitivity sST2 in 8444 men and women (25-74 years) from the FINRISK97 prospective population cohort. Cox proportional hazards modelling evaluated the ability of sST2 to predict fatal and non-fatal heart failure, CVD (coronary heart disease, stroke), diabetes, and death over 15 years follow-up. Discrimination and reclassification statistics for 10-year absolute risks compared the ability of sST2 to improve upon Framingham risk factors (FRF), N-terminal pro-brain natriuretic peptide (NT-proBNP), renal function (eGFR) and prevalent valvular heart disease (VHD).RESULTS: sST2 showed suggestive but non-significant associations with heart failure {(HR per 1 SD of log sST2 1.06; 95% CI 0.96 to 1.17 (562 events))}, and with CVD (1.01 95% CI 0.94 to 1.08) (914 events) after adjustment for FRF, NT-proBNP, eGFR and VHD. sST2 significantly predicted death from all causes following similar adjustment ({HR 1.09 (95% CI 1.01 to 1.19) (974 events))}. No improvement in the c-index was observed for models adding sST2 to the risk factors.CONCLUSIONS: In a healthy general population from Finland, sST2 did not improve long-term prediction of cardiovascular events including heart failure or all-cause mortality.
AB - OBJECTIVES: We hypothesised that soluble ST2 (sST2) levels can identify people with elevated risk of subsequent cardiovascular disease (CVD) and add to existing risk prediction algorithms.BACKGROUND: ST2 is a receptor for the inflammatory cytokine IL33. Increased sST2 levels have been associated with heart failure and death in acute myocardial infarction patients and in the general population.METHODS: We measured high-sensitivity sST2 in 8444 men and women (25-74 years) from the FINRISK97 prospective population cohort. Cox proportional hazards modelling evaluated the ability of sST2 to predict fatal and non-fatal heart failure, CVD (coronary heart disease, stroke), diabetes, and death over 15 years follow-up. Discrimination and reclassification statistics for 10-year absolute risks compared the ability of sST2 to improve upon Framingham risk factors (FRF), N-terminal pro-brain natriuretic peptide (NT-proBNP), renal function (eGFR) and prevalent valvular heart disease (VHD).RESULTS: sST2 showed suggestive but non-significant associations with heart failure {(HR per 1 SD of log sST2 1.06; 95% CI 0.96 to 1.17 (562 events))}, and with CVD (1.01 95% CI 0.94 to 1.08) (914 events) after adjustment for FRF, NT-proBNP, eGFR and VHD. sST2 significantly predicted death from all causes following similar adjustment ({HR 1.09 (95% CI 1.01 to 1.19) (974 events))}. No improvement in the c-index was observed for models adding sST2 to the risk factors.CONCLUSIONS: In a healthy general population from Finland, sST2 did not improve long-term prediction of cardiovascular events including heart failure or all-cause mortality.
KW - Adult
KW - Age Distribution
KW - Aged
KW - Cardiovascular Diseases/blood
KW - Female
KW - Finland
KW - Follow-Up Studies
KW - Forecasting
KW - Heart Failure/blood
KW - Humans
KW - Incidence
KW - Interleukin-1 Receptor-Like 1 Protein
KW - Male
KW - Middle Aged
KW - Natriuretic Peptide, Brain/blood
KW - Peptide Fragments/blood
KW - Population Surveillance/methods
KW - Predictive Value of Tests
KW - Prognosis
KW - Prospective Studies
KW - Protein Precursors
KW - Receptors, Cell Surface/blood
KW - Risk Assessment
KW - Risk Factors
KW - Sex Distribution
KW - Survival Rate/trends
U2 - 10.1136/heartjnl-2014-305968
DO - 10.1136/heartjnl-2014-305968
M3 - SCORING: Journal article
C2 - 25080471
VL - 100
SP - 1715
EP - 1721
JO - HEART
JF - HEART
SN - 1355-6037
IS - 21
ER -
