Abstract 17688: Soluble ST2 Concentration Predicts 1-Year Outcome in Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI)
Introduction: Aortic valve stenosis due to calcification is the leading valvular heart disease in elderly patients. sST2 has been introduced as a novel biomarker in patients suffering from heart failure for better risk stratification. Here in this study we sought to investigate whether sST2 is useful for risk stratification and prediction of mortality in patients undergoing transcatheter aortic valve implantation (TAVI).
Materials and Methods: A total of 274 patients undergoing TAVI were included in this study (149 female; age 80 years±0.5SEM; EUROSCORE 24±2SEM). Plasma samples were obtained pre-interventionally and analyzed for sST2 using commercially available ELISA kits. Patients were clinically followed-up regularly for one year after TAVI.
Results: Median sST2 plasma concentration in these patients was high with 6370 pg/ml (IQR 4371-11721 pg/ml). In a Cox regression analysis sST2 plasma concentration evidenced to be associated with increased mortality (changes per pg/ml sST2 concentration; HR 1.00006 95%(1.00004-1.00009); p<0.001). An optimal cut-off by means of the Youden-Index was calculated (10070 pg/ml) and patients retrospectively divided in two cohorts in those above (31.3%) and those beyond (68.7%) this value. These two groups were then compared regarding mortality: After one year patients with a sST2 concentration above the cut-off of 10070 pg/ml evidenced a significantly increased mortality (49.2% vs 23.2%; OR 3.21 95%CI (1.70-6.04); p<0.001; Figure 1). After correction for confounders in a multivariate Cox regression analysis sST2 concentration (1.00009 95%CI (1.00002-1.00016); p=0.01) remained associated with mortality.
Conclusions: sST2 levels were associated with one-year mortality after TAVI. We assume that sST2 could serve as a very helpful indicator for assessing the patient’s cardiovascular risk. It might help identify patients evaluated for TAVI at high risk for death in whom conservative treatment should be considered.
Author Disclosures: B. Wernly: None. M. Lichtenauer: None. M. Ausserwinkler: None. S. Eder: None. U.C. Hoppe: None. C. Jung: None. U. Landmesser: None. H. Figulla: None. A. Lauten: None.
- © 2016 by American Heart Association, Inc.