| Objective: To investigate whether serum soluble ST2(s ST2),N-terminal pro-brain natriuretic peptide(NT-pro BNP),and echocardiography are superior to single index in the evaluation of prognosis in patients with chronic heart failure(CHF).Method: This study was a retrospective analysis.A total of 71 inpatients diagnosed with chronic heart failure diagnosed in Anhui Provincial Hospital from March 2017 to June 2017 were enrolled.Venous blood was collected and s ST2 values were determined by enzyme-linked immunosorbent assay(ELISA)and NT-pro BNP were determined by electrochemiluminescence.Echocardiography was performed to record left ventricular end diastolic diameter(LVDD)and left ventricular ejection fraction(LVEF)values.The cumulative incidence of cardiovascular death or hospital-accumulated end points was used as the end point of the event.The patients were followed up after discharge,and the incidence of endpoint events within 6 months and 1 year was recorded for statistical analysis.RESULTS: 1)Baseline data: A total of 71 patients were included in the study,withan average age of 67.24±7.51 years,39 males(55%)and 32 females(45%).Of these,27 had hypertension(38%),6 had diabetes(0.08%),and 3 had cerebral infarction(0.04%).In the selected cases,the cardiac function was graded in 25 cases(35.2%)of NYHA II,24 cases(33.8%)of NYHA III,and 22 cases(31.0%)of NYHA IV.2)Follow-up results: Serum soluble ST2 predicted the area under the ROC curve of risk of re-admission in patients with heart failure within 6 months was 0.820,but the difference was not statistically significant(P=0.063).According to the ROC curve coordinate point,when the optimal threshold for s ST2 was set to 3659.58 ng/ml,the sensitivity was 66.7% and the specificity was 96.8%.The area under the NT-pro BNP curve was 0.926 and the difference was statistically significant(P=0.013).When the threshold was 21520,the sensitivity and specificity reached a maximum of 100% and 90.5%,respectively.The combined diagnosis of ST2,NT-pro BNP,LVEF and LVDD was higher.The ROC area was 0.995,and the difference was statistically significant(P=0.004).The sensitivity was 100% and the specificity was 98.4%.The area under the ROC curve of patients with re-admitted heart failure within 1 year after diagnosis of serum soluble ST2 was 0.755,and the difference was statistically significant(P=0.028).The ROC area of NT-pro BNP,s ST2,LVEF and left ventricular diastolic diameter was 0.966,and the difference was statistically significant(P < 0.001)with sensitivity of 100% and specificity of 83.1%.Conclusion: 1)Serum s ST2 and NT-pro BNP levels can reflect the severity of heart failure in patients;2)The higher the serum s ST2 and NT-pro BNP levels,the higher the mortality rate due to cardiovascular events and the re-admission rate of patients with heart failure within 1 year;3)s ST2,NT-pro BNP combined with echocardiography can better predict the poor prognosis of patients with heart failure,and it is of great significance for the evaluation of the diagnosis and treatment of patients with heart failure. |
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