Clin Res Cardiol (2021). 10.1007/s00392-021-01933-9

Limited value of ST2 to detect systolic heart failure compared to NT-proBNP

M. Natale1, M. Harbrücker1, S.-H. Kim1, S. Lindner1, M. Borggrefe1, T. Bertsch2, T. Roth3, S. Lang1, I. Akin1, M. Behnes1, für die Studiengruppe: CIBER

1I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 2Institut für klinische Chemie und Laboratoriumsmedizin und Transfusionsmedizin, Klinikum Nürnberg Nord, Nürnberg; 3Institut für Experimentelle u. Klinische Pharmakologie, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen;

Purpose: Prevention and early treatment of systolic heart failure (HFrEF) is ofmajor importance to reduce hospitalization and mortality. ST2, a novel biomarker,might be useful for early diagnosis of left ventricular dysfunction and thus lead tobetter clinical outcomes. This study aims to evaluate the association between ST2and left ventricular ejection fraction (LVEF) assessed by echocardiography. Methods: Patients undergoing routine echocardiography were prospectivelyenrolled in the present monocentric study. Patients with right ventriculardysfunction (TAPSE < 17 mm) were excluded. Blood samples for measurementsof ST2 and NT-proBNP were collected at the day of echocardiographicexamination. Subgroups based on LVEF grades were defined (left ventricularejection fraction (LVEF) > 60 % (n=37); I: LVEF > 55 - ≤ 60% (n=40), II: LVEF> 45 - ≤ 55 % (n=32), III: LVEF > 35- ≤ 45 % (n=22), IV: LVEF ≤ 35 % (n=15). Results: A total of 146 patients were included. Levels of ST2 as well asNT-proBNP increased significantly according to decreasing LVEF (ST2: p=0.027,NT-proBNP: p=0.0001). Furthermore, ST2 correlated significantly with LVEF(p=0.014). However, ST2 was not able to discriminate patients with severe leftventricular dysfunction LVEF Grade IV, whereas NT-proBNP was (ST2:AUC=0.591, p=0.249; NT-proBNP: AUC=0.84, p=0.0001). This was also provenin multivariable logistic regression models, where only NT-proBNP sustainedsignificantly associated with LVEF IV (NT-proBNP: OR=1, p=0.018; ST2:OR=0.98; p=0.342) after adjusting with age, sex, creatinine, arterial hypertensionand coronary artery disease. Conclusions: ST2 reveals limited diagnostic value for discrimination of systolicheart failure compared to the reference biomarker NT-proBNP.

https://dgk.org/kongress_programme/ht2021/P86.htm