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Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes.


ABSTRACT: ST2 is involved in cardioprotective signaling in the myocardium and has been identified as a potentially promising biomarker in heart failure (HF). We evaluated ST2 levels and their association with functional capacity and long-term clinical outcomes in a cohort of ambulatory patients with HF enrolled in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) study-a multicenter, randomized study of exercise training in HF.HF-ACTION randomized 2331 patients with left ventricular ejection fraction <0.35 and New York Heart Association class II to IV HF to either exercise training or usual care. ST2 was analyzed in a subset of 910 patients with evaluable plasma samples. Correlations and Cox models were used to assess the relationship among ST2, functional capacity, and long-term outcomes. The median baseline ST2 level was 23.7 ng/mL (interquartile range, 18.6-31.8). ST2 was modestly associated with measures of functional capacity. In univariable analysis, ST2 was significantly associated with death or hospitalization (hazard ratio, 1.48; P<0.0001), cardiovascular death or HF hospitalization (hazard ratio, 2.14; P<0.0001), and all-cause mortality (hazard ratio, 2.33; P<0.0001; all hazard ratios for log2 ng/mL). In multivariable models, ST2 remained independently associated with outcomes after adjustment for clinical variables and amino-terminal pro-B-type natriuretic peptide. However, ST2 did not add significantly to reclassification of risk as assessed by changes in the C statistic, net reclassification improvement, and integrated discrimination improvement.ST2 was modestly associated with functional capacity and was significantly associated with outcomes in a well-treated cohort of ambulatory patients with HF although it did not significantly affect reclassification of risk.URL: http://www.clinicaltrials.gov. Unique identifier: NCT00047437.

SUBMITTER: Felker GM 

PROVIDER: S-EPMC4188425 | biostudies-literature | 2013 Nov

REPOSITORIES: biostudies-literature

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Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes.

Felker G Michael GM   Fiuzat Mona M   Thompson Vivian V   Shaw Linda K LK   Neely Megan L ML   Adams Kirkwood F KF   Whellan David J DJ   Donahue Mark P MP   Ahmad Tariq T   Kitzman Dalane W DW   Piña Ileana L IL   Zannad Faiez F   Kraus William E WE   O'Connor Christopher M CM  

Circulation. Heart failure 20131008 6


<h4>Background</h4>ST2 is involved in cardioprotective signaling in the myocardium and has been identified as a potentially promising biomarker in heart failure (HF). We evaluated ST2 levels and their association with functional capacity and long-term clinical outcomes in a cohort of ambulatory patients with HF enrolled in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) study-a multicenter, randomized study of exercise training in HF.<h4>Methods and  ...[more]

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