Soluble ST2 Has a Prognostic Role in Patients With Suspected Sepsis
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background: Soluble suppression of tumorigenicity 2 (sST2) has emerged as a novel biomarker for heart failure, and serum sST2 concentrations could be increased in inflammatory diseases. We explored whether sST2 is related to cardiac dysfunction/failure and has a prognostic role in patients with suspected sepsis. Methods: In a total of 397 patients with suspected sepsis, sST2 concentrations were measured by using the Presage ST2 Assay (Critical Diagnostics, USA). sST2 concentrations were analyzed according to procalcitonin (PCT) concentrations, cardiovascular subscores of the sepsis-related organ failure assessment (SOFA) score, and clinical outcomes. Results: sST2 concentrations were increased significantly according to the five groups of PCT concentrations and cardiovascular subscores of the SOFA score (P<0.000001 and P=0.036, respectively). In-hospital mortality was significantly higher among patients with sST2 concentrations above 35 ng/mL (P=0.0213) and among patients with increased concentrations of both sST2 and PCT (P=0.0028). Conclusions: sST2 seems to be related to both cardiac dysfunction/failure and severity in sepsis. Measurement of sST2 and PCT in combination would be useful for risk stratification and prognosis prediction in patients with suspected sepsis.
Abstract
Background: Soluble suppression of tumorigenicity 2 (sST2) has emerged as a novel biomarker for heart failure, and serum sST2 concentrations could be increased in inflammatory diseases. We explored whether sST2 is related to cardiac dysfunction/failure and has a prognostic role in patients with suspected sepsis. Methods: In a total of 397 patients with suspected sepsis, sST2 concentrations were measured by using the Presage ST2 Assay (Critical Diagnostics, USA). sST2 concentrations were analyzed according to procalcitonin (PCT) concentrations, cardiovascular subscores of the sepsis-related organ failure assessment (SOFA) score, and clinical outcomes. Results: sST2 concentrations were increased significantly according to the five groups of PCT concentrations and cardiovascular subscores of the SOFA score (P<0.000001 and P=0.036, respectively). In-hospital mortality was significantly higher among patients with sST2 concentrations above 35 ng/mL (P=0.0213) and among patients with increased concentrations of both sST2 and PCT (P=0.0028). Conclusions: sST2 seems to be related to both cardiac dysfunction/failure and severity in sepsis. Measurement of sST2 and PCT in combination would be useful for risk stratification and prognosis prediction in patients with suspected sepsis.
참고문헌 (24)
- Weinberg EO, "Expression and regulation of ST2, an interleukin-1 receptor family member, in cardiomyocytes and myocardial infarction", Circulation, 106, pp.2961~2966 (2002)
- Weinberg EO, "ST2 protein in heart disease: from discovery to mechanisms and prognostic value", Biomark Med, 3, pp.495~511 (2009)
- Shah RV, "Soluble ST2 and galectin-3 in heart failure", Clin Lab Med, 34, pp.87~97 (2014)
- Yancy CW, "American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines. 2013 ACCF", AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation, J Am Coll Cardiol, pp.2013, 62[DOI]
- Dellinger RP, "Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012", Intensive Care Med, 39, pp.165~228 (2013)
- Winters BD, "Long-term mortality and quality of life in sepsis: a systematic review", Crit Care Med, 38, pp.1276~1283 (2010)
- Vincent JL, "The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction", failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine, 1996, pp.22, 707~710
- Wacker C, "Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis", Lancet Infect Dis, 13, pp.426~435 (2013)
- Michael Meisner, "Update on Procalcitonin Measurements", Annals of Laboratory Medicine, 34(4), pp.263~273 (2014), 대한진단검사의학회
- Mueller T, "The Presage(®) ST2 Assay: analytical considerations and clinical applications for a high-sensitivity assay for measurement of soluble ST2", Expert Rev Mol Diagn, 13, pp.13~30 (2013)
- Brunner M, "Increased levels of soluble ST2 protein and IgG1 production in patients with sepsis and trauma", Intensive Care Med, 30, pp.1468~1473 (2004)
- Dieplinger B, "Analytical and clinical evaluation of a novel high-sensitivity assay for measurement of soluble ST2 in human plasma-the Presage ST2 assay", Clin Chim Acta, 409, pp.33~40 (2009)
- Alves-Filho JC, "Interleukin-33 attenuates sepsis by enhancing neutrophil influx to the site of infection", Nat Med, 16, pp.708~712 (2010)
- Hoogerwerf JJ, "Soluble ST2 plasma concentrations predict mortality in severe sepsis", Intensive Care Med, 36, pp.630~637 (2010)
- Felker GM, "Soluble ST2 in ambulatory patients with heart failure : Association with functional capacity and long-term outcomes", Circ Heart Fail, 6, pp.1172~1179 (2013)
- Kim H, "Plasma neutrophil gelatinase-associated lipocalin as a biomarker for acute kidney injury in critically ill patients with suspected sepsis", Clin Biochem, 46, pp.1414~1418 (2013)
- Hur M, "Diagnostic and prognostic utilities of multimarkers approach using procalcitonin, B-type natriuretic peptide, and neutrophil gelatinase-associated lipocalin in critically ill patients with suspected sepsis", BMC Infect Dis, 14, pp.224~ (2014)
- Parenica J, "Soluble ST2 levels in patients with cardiogenic and septic shock are not predictors of mortality", Exp Clin Cardiol, 17, pp.205~209 (2012)
- Tian G, "Serum levels of procalcitonin as a biomarker for differentiating between sepsis and systemic inflammatory response syndrome in the neurological intensive care unit", J Clin Neurosci, 21, pp.1153~1158 (2014)
- Lu J, "Establishment of reference intervals for soluble ST2 from a United States population", Clin Chim Acta, 411, pp.1825~1826 (2010)
- Di Somma S, "Opinion paper on innovative approach of biomarkers for infectious diseases and sepsis management in the emergency department", Clin Chem Lab Med, 51, pp.1167~1175 (2013)
- Schuetz P, "Do sepsis biomarkers in the emergency room allow transition from bundled sepsis care to personalized patient care?", Curr Opin Crit Care, 18, pp.341~349 (2012)
- Riedel S, "Laboratory detection of sepsis: biomarkers and molecular approaches", Clin Lab Med, 33, pp.413~437 (2013)