International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 13, No. 12, December 2023 | pp. 89–96

DOI: 10.46882/2023/IJMMS/130089

Original Research Article

Diagnostic Utility of Serum Soluble ST2 versus N-Terminal Pro-Brain Natriuretic Peptide for Predicting Mortality in Acute Decompensated Heart Failure

Charles O. Igwe¹, Rachel L. Sanon², Anthony D. Boateng¹*

¹Department of Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria.

²Department of Cardiology, Faculty of Health Sciences, Université de Ouagadougou, Ouagadougou, Burkina Faso.

Abstract:

Risk stratification in acute decompensated heart failure (ADHF) remains challenging, necessitating the evaluation of novel biomarkers that reflect myocardial stretch and fibrosis. This prospective cohort study evaluated the diagnostic accuracy of serum soluble ST2 (sST2) compared to N-terminal pro-brain natriuretic peptide (NT-proBNP) for predicting 90-day all-cause mortality in ADHF. We evaluated 130 adult patients admitted to cardiac wards with a confirmed diagnosis of ADHF. Serum sST2 was quantified using an enzyme-linked immunosorbent assay (ELISA) and NT-proBNP via electrochemiluminescence at admission, and patients were tracked for 90 days. A total of 22 deaths occurred during the follow-up period, representing a mortality rate of 16.9%. Deceased patients exhibited significantly higher mean baseline sST2 levels (78.5 ± 14.2 ng/mL) compared to survivors (34.2 ± 6.8 ng/mL, p < 0.001). Receiver Operating Characteristic (ROC) analysis showed that a baseline sST2 cutoff value of 45 ng/mL predicted 90-day mortality with a sensitivity of 86.4%, a specificity of 81.5%, and an Area Under the Curve (AUC) of 0.89 (95% CI = 0.82–0.95). In comparison, NT-proBNP achieved an AUC of 0.78 (p < 0.05). Multivariate Cox proportional hazards regression demonstrated that elevated sST2 remained an independent predictor of mortality (HR = 3.4, 95% CI = 1.6–7.2, p < 0.01) after adjusting for left ventricular ejection fraction and renal function. Serum sST2 offers superior predictive precision for short-term mortality in ADHF compared to NT-proBNP, serving as a valuable tool to guide intensive post-discharge clinical monitoring.

Keywords: Acute Decompensated Heart Failure, Soluble ST2, NT-proBNP, Biomarkers, Mortality Predictors, Myocardial Fibrosis

Manuscript Timeline: Received: September 14, 2023; Revised: October 22, 2023; Accepted: November 11, 2023; Published: December 14, 2023.

Citation: Igwe CO, Sanon RL, Boateng AD. Diagnostic Utility of Serum Soluble ST2 versus N-Terminal Pro-Brain Natriuretic Peptide for Predicting Mortality in Acute Decompensated Heart Failure. International Journal of Medicine and Medical Sciences, 2023, 13(12): 89–96. DOI: 10.46882/2023/IJMMS/130089

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