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Heart failure and cardiomyopathies
Original research article
The prognostic value of sST2 and galectin-3 considering different aetiologies in non-ischaemic heart failure
  1. David Binas1,
  2. Hanna Daniel2,
  3. Anette Richter1,
  4. Volker Ruppert1,
  5. Klaus-Dieter Schlüter3,
  6. Bernhard Schieffer1 and
  7. Sabine Pankuweit1
  8. on behalf of the Competence Network Heart Failure
  1. 1Department of Internal Medicine and Cardiology, Philipps-University Marburg, Marburg, Germany
  2. 2Institute for Medical Biometry and Epidemiology, Philipps-University Marburg, Marburg, Germany
  3. 3Institute of Physiology, Justus-Liebig-University Giessen, Giessen, Germany
  1. Correspondence to Dr Sabine Pankuweit; pankuwei{at}staff.uni-marburg.de

Abstract

Objective Several studies indicate a prognostic value of sST2 and galectin-3 in heart failure (HF). While previous studies focused on ischaemic cause of HF, we investigated the role of sST2 and galectin-3 in patients with non-ischaemic dilated cardiomyopathy (DCM).

Methods sST2 and galectin-3 serum concentrations were measured in 262 subjects with DCM. Survival rates were determined for all-cause mortality (ACM) and cardiac mortality (CM).

Results In a univariate model, sST2 as a continuous variable was a predictor of ACM (HR 1.05; 95% CI 1.03 to 1.07, P<0.001) and CM (HR 1.03; 95% CI 1.00 to 1.06, P=0.040). In the subgroup of patients with inflammatory and/or viral DCM (DCMi⋎viral), the endpoints ACM (HR 1.10; 95% CI 1.05 to 1.17, P<0.001) and CM (HR 1.10; 95% CI 1.02 to 1.18, P=0.013) were significant. In the subgroup of patients with idiopathic DCM, the endpoint ACM (HR 1.04; 95% CI 1.01 to 1.07, P=0.019) was significant. In a multivariate model, the prognostic value of the sST2 main group remained intact for ACM (HR 1.04; 95% CI 1.02 to 1.07, P=0.003).

Univariate and multivariate analysis of galectin-3 as continuous variable did not show any significant result. However, in a quartile model, intermediate values of galectin-3 were significantly associated with a lower event rate of ACM and CM.

Conclusion The study revealed that sST2 predicts ACM and CM in patients with non-ischaemic HF and could be useful especially in patients with inflammatory background. Our findings that intermediate levels of galectin-3 allow for better prognosis were new and different to other investigations.

Trial registration number NCT03090425; Results.

  • sST2
  • soluble ST2
  • Galectin-3
  • Heart failure
  • Dilated Cardiomyopathy

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/openhrt-2017-000750

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    Footnotes

    • Contributors DB performed the ELISA analyses, completed the data and wrote the manuscript. HD performed the statistics. AR and VR included the patients and data, K-DSU and BS wrote the manuscript. SP initiated the investigations, included patients and patients data, wrote and revised the manuscript.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval Ethics committee of the Medical Faculty of the Philipps-University Marburg.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement There are no additional data available for this paper.

    • Presented at Parts of the data were presented as poster during the Annual meeting of the European Society of Cardiology in Rome 2016 and published as abstract as follows: Eur Heart J, 2016; 37(Suppl_1): 599–983.