| Objective To investigate the diagnosis value of Soluble ST2(Soluble isoform of suppression of tumorigenicity 2,sST2)in patients with acute heart failure,and to evaluate the prognostic value of sST2 in patients with suspected acute heart failure who seek emergency treatment for dyspnea.Methods The selected subjects were from September 2017 to February 2018.Patients with dyspnea were admitted to the emergency department of the First Hospital of Hohhot.Every patient was tested the N-terminal Brain natriuretic peptide(NT-proBNP)and was divided into group with NT-proBNP as the diagnostic criteria.A total of 92 patients(acute heart failure-group A)and 116 patients(non-acute heart failure-group B)were collected.At the same time,the serums which came from 42 healthy subjects excepting acute heart failure were selected as the control group(healthy test-group C).After the collection of serum samples from the three groups,the levels of sST2 were tested uniformly.Baseline data were collected from the enrolled patients in the emergency department of the two groups,and the patients were followed up for 6 months to record whether terminal events occurred.Endpoint events include death from any cause and a second emergency visit or rehospitalization for heart failure.Results A total of 89 end-point events occurred in 208 patients within 6 months of follow-up,including 32 cases of all-cause death and 57 cases of re-emergency visit or hospitalization due to heart failure.Compared with group B,the incidence of endpoint events of group A was higher(79.30% vs 13.80%,P < 0.001),the age of group A was older(70.01±12.42 years vs 64.41±12.58 years,P=0.002).In the comparison of sST2 levels among groups A,B and C,group A was higher than group B(170.73±16.57pg/ml vs 86.47 ±5.51pg/ml,P < 0.05)and group C(170.73±16.57pg/ml vs 66.93 ±13.09pg/ml,P < 0.05);Group B was higher than group C(86.47±5.51pg/ml vs 66.93±13.09pg/ml,P=0.036).In group A,the level of sST2 and NT-proBNP in the endpoint event was higher than that in the non-endpoint event(187.79±20.39pg/ml vs 105.18±5.19pg/ml,P=0.043;10999.79±1224.70ng/l vs 2549.30±651.99ng/l,P=0.001).The area under the ROC curve predicted by sST2 and NT-proBNP for terminal events in group A was 0.830(P=0.001)and 0.883(P=0.001).In group A,the level of sST2 and NT-proBNP in the death group was higher than that in the survival group(236.15±37.86pg/ml vs 139.07±15.12pg/ml,P=0.005;12485.58±1986.98ng/l vs 7691.19±1173.24ng/l,P=0.043).The area under the ROC curve of sST2 and NT-proBNP in predicting the death events in group A was 0.734(P=0.001)and 0.683(P=0.005).In the analysis of related clinical factors of endpoint event occurrence in group A,sST2 and NT-proBNP were proved to be risk factors of endpoint event in group A(P=0.007,P=0.008).In the analysis of related clinical factors of death events in group A,respiratory failure was confirmed to be a risk factor of death events in group A(P=0.006).The level of sST2 in the endpoint event of group B was higher than that in the non-endpoint event(140.72±13.79pg/ml vs 77.79±5.54pg/ml,P=0.001),and there was no statistical difference between the level of NT-proBNP in the endpoint event in group B and that in the non-endpoint event(P > 0.05).The area under the ROC curve of the endpoint event in group B predicted by sST2 was 0.933(P=0.001).In the analysis of related clinical factors of endpoint events in group B,sST2 and pulmonary heart disease were confirmed to be risk factors of endpoint events(P=0.022,P=0.001).Conclusion 1.sST2 is an independent risk factor for endpoint events of group A and group B,and has independent predictive value for endpoint events of group A and group B and death events of group A;The predictive value of sST2 for endpoint event and deaths in acute heart failure was comparable to that of NT-proBNP;2.the level of sST2 in patients with acute heart failure is higher than that in patients with non-acute heart failure,higher than that in healthy subjects,which indicated that thelevel of sST2 has certain diagnostic value for acute heart failure;3.Compared with the non-acute heart failure group,patients in the acute heart failure group were older and had a higher incidence of end-point events. |
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