Biological Variability of Soluble ST2 in Patients with Stable Chronic Heart Failure and Implications for Monitoring

Susan Piper, Julia deCourcey, Roy Sherwood, George Amin-Youssef, Theresa McDonagh

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Soluble ST2 (sST2) is a novel biomarker implicated in myocardial remodelling and fibrosis. Recent studies in normal subjects have suggested the biological variability (BV) of sST2 is significantly lower than that of the B-type natriuretic peptides, BNP & NTproBNP. It may, consequently, be a better biomarker for monitoring patients with chronic heart failure (CHF). To date, no published studies have examined the BV of sST2 in a heart failure population. Blood samples from 50 outpatients with pharmacologically optimised stable CHF and persistent left ventricular dysfunction (ejection fraction (EF) <40%). were collected at baseline, 1 hour, 1 month, 3 months and 6 months. Using log-transformed data, mean intra-individual coefficients of variation (CVI) and subsequent reference change values (RCV) were calculated for both NTproBNP and sST2. Results demonstrate significantly lower CVI and RCV for sST2 compared with NTproBNP at 1 month (12.02 (36%) vs. 36.75 (103%)) p<0.001, 3 months (12.23 (36%) vs. 40.98 (114%)) p<0.001 and 6 months (16.41 (47%) vs. 46.02 (128%)) p<0.001. In conclusion, the BV of sST2 is significantly lower than that of NTproBNP in patients with CHF. These results support previous indications that sST2 may be a better biomarker for monitoring such patients.
Original languageEnglish
JournalAmerican Journal of Cardiology
Early online date21 Apr 2016
Publication statusE-pub ahead of print - 21 Apr 2016


  • Heart Failure
  • Monitoring
  • Biomarkers

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