Effectiveness of the Suppression of Tumorigenicity 2 for Prognosis in Heart Failure: Systematic Reviews
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Objectives: Suppression of tumorigenicity 2 (ST2) reflects activity of the cardioprotective signal and it is a prognostic marker in heart failure. The purpose of this study is to assess the effectiveness of the ST2 for determination of the prognosis of patient with heart failure. Methods: We searched the eight Korean databases and Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library. Total 365 stud- ies were searched and 19 studies were included in the final assessment. Each of the stages from litera- ture search and extraction of data were carried out independently by 2 researchers. We used tools of Scottish Intercollegiate Guidelines Networks for assessment of the quality of studies. Results: The effectiveness of the ST2 was assessed by means of association with prognosis [risk ratio (RR) or odds ratio (OR), accuracy of forecasting of the prognosis, stratification of risk], correlation with the comparators and relevance with clinical symptoms. The RR or OR of the death arising from ST2 was 1.01−4.56, the RR of hospitalization was 1.054−2.4. On the other hand, RR of hospitalization of B-type natriuretic peptide (BNP) was 1.15−2.0, the RR or OR of death arising from N-terminal pro- BNP (NT pro-BNP) was 0.19−1.241. The sensitivity/specificity of the ST2 was 64−87%/51−82% and area under the ROC curve values were 0.689−0.84. The stratification of risk (net reclassification im- provement) on the death rate were reported to be significant at 9.4 and 9.9 in the 2 studies, but 1 study reported that stratification of risk of the death rate was 0.049 and stratification of risk of hos- pitalization rate was 0.0638. The correlation coefficients with BNP was 0.16−0.409 and with NT pro-BNP was 0.28−0.523. Conclusion: The ST2 is effective in determining the prognosis of pa- tients with heart failure.
Abstract
Objectives: Suppression of tumorigenicity 2 (ST2) reflects activity of the cardioprotective signal and it is a prognostic marker in heart failure. The purpose of this study is to assess the effectiveness of the ST2 for determination of the prognosis of patient with heart failure. Methods: We searched the eight Korean databases and Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library. Total 365 stud- ies were searched and 19 studies were included in the final assessment. Each of the stages from litera- ture search and extraction of data were carried out independently by 2 researchers. We used tools of Scottish Intercollegiate Guidelines Networks for assessment of the quality of studies. Results: The effectiveness of the ST2 was assessed by means of association with prognosis [risk ratio (RR) or odds ratio (OR), accuracy of forecasting of the prognosis, stratification of risk], correlation with the comparators and relevance with clinical symptoms. The RR or OR of the death arising from ST2 was 1.01−4.56, the RR of hospitalization was 1.054−2.4. On the other hand, RR of hospitalization of B-type natriuretic peptide (BNP) was 1.15−2.0, the RR or OR of death arising from N-terminal pro- BNP (NT pro-BNP) was 0.19−1.241. The sensitivity/specificity of the ST2 was 64−87%/51−82% and area under the ROC curve values were 0.689−0.84. The stratification of risk (net reclassification im- provement) on the death rate were reported to be significant at 9.4 and 9.9 in the 2 studies, but 1 study reported that stratification of risk of the death rate was 0.049 and stratification of risk of hos- pitalization rate was 0.0638. The correlation coefficients with BNP was 0.16−0.409 and with NT pro-BNP was 0.28−0.523. Conclusion: The ST2 is effective in determining the prognosis of pa- tients with heart failure.
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