Prognostic Value of Soluble ST2 After Myocardial Infarction: A Community Perspective

William S. Jenkins, Veronique Lee Roger, Allan S Jaffe, Susan A. Weston, Omar Abou Ezzeddine, Ruoxiang Jiang, Sheila M. Manemann, Maurice E Sarano

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Soluble ST2 (sST2) is a marker of cardiac mechanical strain hypothesized to adversely impact short-term prognosis after myocardial infarction. We examined the association of sST2 with longer-term outcomes after myocardial infarction in a geographically defined community. Methods: Olmsted County, Minnesota residents who experienced an incident (first-ever) myocardial infarction between November 1, 2002 and December 31, 2012 were prospectively enrolled; sST2 levels were measured. Patients were followed for heart failure and death. Results: We studied 1401 patients with incident myocardial infarction (mean age 67 years; 61% men; 79% non-ST-elevation myocardial infarction). Median sST2 (ng/mL) was 48.7 (25th-75th percentile 32.5-103.3). Soluble ST2 was elevated in 51% of patients. Higher values of sST2 were associated with increased age, female sex, and comorbidities. During 5 years of follow-up, 388 persons died and 360 developed heart failure. After adjustment for age, sex, comorbidities, Killip class, and troponin T, the hazard ratios for death were 1.73 (95% confidence interval [CI], 1.22-2.45) and 3.57 (95% CI, 2.57-4.96) for sST2 tertiles 2 and 3, respectively (P trend <.001). For heart failure, the hazard ratios were 1.67 (95% CI, 1.18-2.37) and 2.88 (95% CI, 2.05-4.05), respectively (P trend <.001). Results were similar among 30-day survivors. Conclusions: In the community, sST2 elevation is present in half of myocardial infarctions. Higher values of sST2 are associated with a large excess risk of death and heart failure independently of other prognostic indicators. Measurement of sST2 should be considered for risk stratification after myocardial infarction.

Original languageEnglish (US)
JournalAmerican Journal of Medicine
DOIs
StateAccepted/In press - 2017

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Myocardial Infarction
Heart Failure
Confidence Intervals
Comorbidity
Troponin T
Survivors

Keywords

  • Heart failure
  • Mortality
  • Myocardial infarction
  • Soluble ST2

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Prognostic Value of Soluble ST2 After Myocardial Infarction : A Community Perspective. / Jenkins, William S.; Roger, Veronique Lee; Jaffe, Allan S; Weston, Susan A.; Abou Ezzeddine, Omar; Jiang, Ruoxiang; Manemann, Sheila M.; Sarano, Maurice E.

In: American Journal of Medicine, 2017.

Research output: Contribution to journalArticle

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title = "Prognostic Value of Soluble ST2 After Myocardial Infarction: A Community Perspective",
abstract = "Background: Soluble ST2 (sST2) is a marker of cardiac mechanical strain hypothesized to adversely impact short-term prognosis after myocardial infarction. We examined the association of sST2 with longer-term outcomes after myocardial infarction in a geographically defined community. Methods: Olmsted County, Minnesota residents who experienced an incident (first-ever) myocardial infarction between November 1, 2002 and December 31, 2012 were prospectively enrolled; sST2 levels were measured. Patients were followed for heart failure and death. Results: We studied 1401 patients with incident myocardial infarction (mean age 67 years; 61{\%} men; 79{\%} non-ST-elevation myocardial infarction). Median sST2 (ng/mL) was 48.7 (25th-75th percentile 32.5-103.3). Soluble ST2 was elevated in 51{\%} of patients. Higher values of sST2 were associated with increased age, female sex, and comorbidities. During 5 years of follow-up, 388 persons died and 360 developed heart failure. After adjustment for age, sex, comorbidities, Killip class, and troponin T, the hazard ratios for death were 1.73 (95{\%} confidence interval [CI], 1.22-2.45) and 3.57 (95{\%} CI, 2.57-4.96) for sST2 tertiles 2 and 3, respectively (P trend <.001). For heart failure, the hazard ratios were 1.67 (95{\%} CI, 1.18-2.37) and 2.88 (95{\%} CI, 2.05-4.05), respectively (P trend <.001). Results were similar among 30-day survivors. Conclusions: In the community, sST2 elevation is present in half of myocardial infarctions. Higher values of sST2 are associated with a large excess risk of death and heart failure independently of other prognostic indicators. Measurement of sST2 should be considered for risk stratification after myocardial infarction.",
keywords = "Heart failure, Mortality, Myocardial infarction, Soluble ST2",
author = "Jenkins, {William S.} and Roger, {Veronique Lee} and Jaffe, {Allan S} and Weston, {Susan A.} and {Abou Ezzeddine}, Omar and Ruoxiang Jiang and Manemann, {Sheila M.} and Sarano, {Maurice E}",
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T1 - Prognostic Value of Soluble ST2 After Myocardial Infarction

T2 - A Community Perspective

AU - Jenkins, William S.

AU - Roger, Veronique Lee

AU - Jaffe, Allan S

AU - Weston, Susan A.

AU - Abou Ezzeddine, Omar

AU - Jiang, Ruoxiang

AU - Manemann, Sheila M.

AU - Sarano, Maurice E

PY - 2017

Y1 - 2017

N2 - Background: Soluble ST2 (sST2) is a marker of cardiac mechanical strain hypothesized to adversely impact short-term prognosis after myocardial infarction. We examined the association of sST2 with longer-term outcomes after myocardial infarction in a geographically defined community. Methods: Olmsted County, Minnesota residents who experienced an incident (first-ever) myocardial infarction between November 1, 2002 and December 31, 2012 were prospectively enrolled; sST2 levels were measured. Patients were followed for heart failure and death. Results: We studied 1401 patients with incident myocardial infarction (mean age 67 years; 61% men; 79% non-ST-elevation myocardial infarction). Median sST2 (ng/mL) was 48.7 (25th-75th percentile 32.5-103.3). Soluble ST2 was elevated in 51% of patients. Higher values of sST2 were associated with increased age, female sex, and comorbidities. During 5 years of follow-up, 388 persons died and 360 developed heart failure. After adjustment for age, sex, comorbidities, Killip class, and troponin T, the hazard ratios for death were 1.73 (95% confidence interval [CI], 1.22-2.45) and 3.57 (95% CI, 2.57-4.96) for sST2 tertiles 2 and 3, respectively (P trend <.001). For heart failure, the hazard ratios were 1.67 (95% CI, 1.18-2.37) and 2.88 (95% CI, 2.05-4.05), respectively (P trend <.001). Results were similar among 30-day survivors. Conclusions: In the community, sST2 elevation is present in half of myocardial infarctions. Higher values of sST2 are associated with a large excess risk of death and heart failure independently of other prognostic indicators. Measurement of sST2 should be considered for risk stratification after myocardial infarction.

AB - Background: Soluble ST2 (sST2) is a marker of cardiac mechanical strain hypothesized to adversely impact short-term prognosis after myocardial infarction. We examined the association of sST2 with longer-term outcomes after myocardial infarction in a geographically defined community. Methods: Olmsted County, Minnesota residents who experienced an incident (first-ever) myocardial infarction between November 1, 2002 and December 31, 2012 were prospectively enrolled; sST2 levels were measured. Patients were followed for heart failure and death. Results: We studied 1401 patients with incident myocardial infarction (mean age 67 years; 61% men; 79% non-ST-elevation myocardial infarction). Median sST2 (ng/mL) was 48.7 (25th-75th percentile 32.5-103.3). Soluble ST2 was elevated in 51% of patients. Higher values of sST2 were associated with increased age, female sex, and comorbidities. During 5 years of follow-up, 388 persons died and 360 developed heart failure. After adjustment for age, sex, comorbidities, Killip class, and troponin T, the hazard ratios for death were 1.73 (95% confidence interval [CI], 1.22-2.45) and 3.57 (95% CI, 2.57-4.96) for sST2 tertiles 2 and 3, respectively (P trend <.001). For heart failure, the hazard ratios were 1.67 (95% CI, 1.18-2.37) and 2.88 (95% CI, 2.05-4.05), respectively (P trend <.001). Results were similar among 30-day survivors. Conclusions: In the community, sST2 elevation is present in half of myocardial infarctions. Higher values of sST2 are associated with a large excess risk of death and heart failure independently of other prognostic indicators. Measurement of sST2 should be considered for risk stratification after myocardial infarction.

KW - Heart failure

KW - Mortality

KW - Myocardial infarction

KW - Soluble ST2

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