Author + information
- Hanna Kim Gaggin,
- Shweta Motiwala,
- Anju Bhardwaj,
- Jackie Szymonifka,
- Kimberly Parks and
- James Januzzi
In heart failure (HF), concentrations of the interleukin-1 receptor family member ST2 predict prognosis. We recently found beta blockers (BB) may affect ST2 concentrations. It remains unclear if ST2 concentrations identify benefit of BB.
151 subjects with HF due to left ventricular systolic dysfunction (LVSD) were examined; >98% were taking BB at enrollment. Subjects had a measurement of soluble (s) ST2 (Presage ST2, Critical Diagnostics) and followed over 10 months. Cardiovascular (CV) events were examined as a function of sST2 status (“low” ≤ 35 vs. “high” > 35 ng/mL) and final achieved BB dose (“high” ≥50 vs. “low” <50 mg daily equivalent dose of metoprolol succinate).
Patients with low sST2 that achieved high-dose BB had the lowest CV event rate at 0.53 events (Figure A, p=0.001), and best event-free survival (Figure B, p=0.003). Those with low sST2/low-dose BB, or high sST2/high-dose BB had intermediate outcomes. Those with high sST2/low-dose BB had the highest CV event rate and worst event-free survival. Compared to low sST2/high-dose BB, those with high sST2 achieving only low-dose BB had an odds ratio (OR) of 6.77 (p<0.001) for a CV event. Patients with low sST2/low-dose BB or high sST2/high-dose BB had intermediate ORs for CV events approximately 2 times higher (p=0.18 and 0.02). Similar findings were present for HF hospitalization and CV death.
In HF due to LVSD, sST2 measurement identifies chronic HF patients who particularly benefit from high-dose BB therapy.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: New Paradigms in Prognostic Role of Biomarkers in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1265-298
- 2013 American College of Cardiology Foundation