The prognostic value of sST2 in connective tissue disease patients with pulmonary hypertension. (30th January 2022)

• Record Type: Journal Article
• Authors: Ye, Huangshu; Wu, Qianwen; Zhang, Ning; Shi, Jing; Zhang, Haifeng; Wang, Qiang; Zhang, Miaojia; Sun, Xiaoxuan
• Is Part Of: Rheumatology. Volume 61:Number 10(2022)
• Page Start: 3989
• Page End: 3996
• Publication Date: 2022-01-30
• Subjects: soluble suppression of tumorigenicity 2 (sST2) -- pulmonary hypertension (PH) -- connective tissue disease (CTD) -- clinical worsening; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/keac055
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objectives: Pulmonary arterial hypertension (PAH) is a severe complication of CTD, being one of the leading causes of mortality for patients with this condition. Soluble suppression of tumorigenicity 2 (sST2) is a novel biomarker associated with adverse clinical outcomes in cardiovascular patients. In this study, we investigated the role of sST2 as a predictor of poor clinical outcome in patients with CTD associated with pulmonary hypertension (CTD-PH). Methods: This retrospective cohort study enrolled 71 CTD-PH patients diagnosed by echocardiography. Twenty-one CTD patients without PH were selected for a control group. A receiver operating characteristic (ROC) curve assessed the predictive value of sST2 in assessing 3-year clinical worsening. Hazard ratios associated with potential predictors of clinical worsening were estimated using Cox proportional hazard models. The primary end point was clinical worsening. Results: The level of sST2 was significantly elevated in CTD-PH patients compared with the control group. After a mean follow-up of 25.29 (1.88) months, end point events occurred in 26 patients. sST2 was an independent predictor of clinical worsening and all-cause death in patients with CTD-PH. sST2 ≥ 39.99 ng/ml discriminated 3-year clinical worsening with a sensitivity and specificity of 100% and 84.9%, respectively. The patients with both higher levels of sST2 (≥39.99 ng/ml) and N-terminal pro-brain natriuretic peptide (NT-proBNP) (≥300 ng/l) had the worst prognosis. Conclusion: sST2 ≥ 39.99 ng/ml predicts higher incidence of clinical worsening events in CTD-PH patients. Furthermore, patients with elevated sST2 had significantly worse prognosis among those with high NT-proBNP.