With studies of ST2 underway or recently completed in New Zealand, Austria, and Spain, international hopes for the marker are high and early results are encouraging. Jordi Ordóñez-Llanos, MD, PhD, a professor of clinical biochemistry at Hospital Santa Creu i Sant Paul in Barcelona, reports that his research group tested ST2 in a cohort of patients with established heart failure and is submitting the results for publication.
"Soluble ST2 emerges in this study as a novel biomarker
for the future prediction of such an unpredictable event as sudden cardiac
death," Dr. Ordóñez told CAP TODAY.
ST2—along with NT-proBNP, glomerular filtration
rate, and left atrial size—proved to be an independent variable
predictive of future sudden cardiac death events. The combination of soluble
ST2 and NT-proBNP was a better prognosticator than either alone.
But the group also did a study measuring heart failure
patients at baseline, after two weeks of intensive treatment, and at a
one full year followup. Its findings: "ST2 was predictive of events in
this population with long-term followup, even stronger than NT-proBNP."
In addition, the change in ST2 values between week two and baseline was
more predictive for long-term followup than the single baseline or week
"In other words," Dr. Ordóñez says,
"ST2 monitoring during two weeks in an outpatient clinic was useful above
and beyond NT-proBNP and clinical evaluation for predicting long-term
Natriuretic peptides are here to stay, Dr. Ordóñez
believes, particularly in the emergency department, but his study suggests
there may be a possible additional role for ST2 in monitoring heart failure
Anne Paxton is a writer in Seattle.