Meta-Analysis of Soluble Suppression of Tumorigenicity-2 and Prognosis in Acute Heart Failure

Alberto Aimo, Giuseppe Vergaro, Andrea Ripoli, Antoni Bayes-Genis, Domingo A. Pascual Figal, Rudolf A. de Boer, Johan Lassus, Alexandre Mebazaa, Etienne Gayat, Tobias Breidthardt, Zaid Sabti, Christian Mueller, Hans Peter Brunner-La Rocca, W. H.Wilson Tang, Justin L. Grodin, Yuhui Zhang, Paulo Bettencourt, Alan S. Maisel, Claudio Passino, James L. JanuzziMichele Emdin

Research output: Contribution to journalArticlepeer-review

103 Scopus citations


Objectives The aim of this study was to perform a meta-analysis of currently available data regarding the prognostic significance of soluble suppression of tumorigenecity–2 (sST2) concentration in acute heart failure (AHF). Background Concentration of sST2 may have prognostic value in AHF. A comprehensive assessment of all available studies regarding sST2 in AHF is lacking. Methods Three databases (MEDLINE, Cochrane Library, and Scopus) were searched. Inclusion criteria were follow-up studies, papers published in English, enrollment of patients with AHF, and availability of median hazard ratios for all-cause death and other outcome measures, when available. Results Ten studies were included, with a global population of 4,835 patients and a median follow-up duration of 13.5 months. The following global hazard ratios calculated for log2(sST2) were admission sST2 and all-cause death, 2.46 (95% confidence interval [CI]: 1.80 to 3.37; p < 0.001); discharge sST2 and all-cause death, 2.06 (95% CI: 1.37 to 3.11; p < 0.001); admission sST2 and cardiovascular death, 2.29 (95% CI: 1.41 to 3.73; p < 0.001); discharge sST2 and cardiovascular death, 2.20 (95% CI: 1.48 to 3.25; p < 0.001); admission sST2 and heart failure (HF) hospitalization, 1.21 (95% CI: 0.96 to 1.52; p = 0.060); discharge sST2 and HF hospitalization, 1.54 (95% CI: 1.03 to 2.32; p = 0.007); admission sST2 and all-cause death or HF hospitalization, 1.74 (95% CI: 1.24 to 2.45; p < 0.001); and discharge sST2 and all-cause death or HF hospitalization, 1.63 (95% CI: 1.14 to 2.33; p < 0.001). Conclusions Plasma sST2 has prognostic value with respect to all-cause and cardiovascular death as well as the composite outcome of all-cause death or HF hospitalization, with both admission and discharge values having prognostic efficacy. Discharge sST2, but not admission sST2, is predictive of HF rehospitalization during follow-up.

Original languageEnglish (US)
Pages (from-to)287-296
Number of pages10
JournalJACC: Heart Failure
Issue number4
StatePublished - Apr 1 2017


  • acute heart failure
  • meta-analysis
  • prognosis
  • sST2

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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