Researchers have identified a new biomarker for heart failure, ST2, which also strongly predicts the risk of death in heart patients.
Heart failure is a condition in which the heart muscle is damaged and cannot pump blood efficiently and it is a major cause of cardiac death. Its diagnosis has been a challenge, since its symptoms are similar to many other conditions.
The study was conducted by a team of researchers led by James Januzzi at the MGH Cardiology Division.
Earlier PRIDE study has identified a number of candidate biomarkers for diagnosis which showed that a protein called NT-proBNP, one of the natriuretic peptides, could confirm or rule out a diagnosis of heart failure in emergency room patients with shortness of breath. In addition NT-proBNP strongly predicted death among such patients.
Some recent studies have shown that ST2, which appears to have a role in the inflammatory response, also may be expressed within the heart in situations involving stress to the cardiac muscle, including heart failure.
As part of the current study, to more closely examine ST2's potential as a heart failure biomarker, researchers analysed data and blood samples of almost 600 individuals complaining shortness of breath, from the PRIDE study participants.
The study confirmed ST2 as a novel marker of heart failure, finding the highest levels among participants with the disorder.
Elevated ST2 levels strongly predicted the risk of death during the year after the initial hospital visit, even among patients who did not have heart failure. In fact, ST2 appeared to be a stronger predictor of death than was NT-proBNP, and a combination of both biomarkers gave the most accurate prediction for all study participants.
"We have confirmed the potential importance of ST2 to predict risk. What we don't have now is information on how ST2 changes after adequate heart failure treatment and what that tells us about patients' response to therapy. It's likely that patterns of multiple biomarkers will help us identify patients with heart failure who remain at a high risk for death, even though they appear to be symptomatically improving during treatment," Januzzi said.