High Soluble Suppression of Tumorigenicity-2 (sST2) is A Risk Factor for Rehospitalization and Mortality in Chronic Heart Failure Patients with Reduced Ejection Fraction
Melissa Dharmawan1, Luh Oliva Saraswati Suastika1*, Ida Bagus Rangga Wibhuti1, I Nyoman Wiryawan1, Eliana Susilowati1, Anak Agung Wiradewi Lestari2, and I Gusti Bagus Putu Suwarjana Kaler3
Abstract
Background: Chronic heart failure (CHF) impairs the heart’s pumping ability due to structural or functional abnormalities. It is a leading cause of death worldwide, with mortality rates of 10-50% based on severity. Risk stratification methods help predict CHF prognosis. ST2, an interleukin-1 receptor, is valuable for forecasting rehospitalization and cardiovascular events. In progressive heart failure, increased sST2 receptor expression inhibits the protective effects of IL-33, worsening the condition. Methods: Chronic heart failure patients with LVEF <40% were studied in a cohort design. After sST2 blood samples were taken, patients were followed for 1 year and 10 months to monitor Major Cardiovascular Events (MACEs) like rehospitalization and mortality. Baseline characteristics included demographic, clinical, comorbidity, laboratory, and echocardiographic data. The best sST2 cut-off was determined using ROC curves. Kaplan-Meier and Cox Regression analyses assessed outcomes using SPSS 26.0. Results: All 80 samples completed the study with no drop-outs. The optimal sST2 cut-off for predicting Major Cardiovascular Events (MACEs) was >19.38 ng/mL (AUC 0.668, CI 95% 0.542-0.794; p=0.023), with 66.7% sensitivity and 66.1% specificity. Survival analysis showed patients with sST2 ≥19.4 ng/mL had lower long-term survival (58.8% vs. 84.8%; p=0.007). Adjusted for age and comorbidities, high sST2 levels significantly predicted MACEs, with a 3.581 times higher risk (95% CI 1.343-9.551; p=0.011) of rehospitalization and mortality. Conclusion: High sST2 levels (≥19.4 ng/mL) were associated as a risk factor of rehospitalization and mortality in chronic heart failure patients with reduced ejection fraction.
Keywords
sST2; chronic heart failure; major cardiovascular events; rehospitalization; mortality due to cardiovascular causes.
Cite This Article
Dharmawan, M., Suastika, L. O. S., Wibhuti, I. B. R., Wiryawan, I. N., Susilowati, E., Lestari, A. A. W., Kaler, I. G. B. P. S. (2024). High Soluble Suppression of Tumorigenicity-2 (sST2) is A Risk Factor for Rehospitalization and Mortality in Chronic Heart Failure Patients with Reduced Ejection Fraction. International Journal of Scientific Advances (IJSCIA), Volume 5| Issue 4: Jul-Aug 2024, Pages 739-750, URL: https://www.ijscia.com/wp-content/uploads/2024/08/Volume5-Issue4-Jul-Aug-No.644-739-750.pdf
Volume 5 | Issue 4: Jul-Aug 2024
