College of American Pathologists
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  Drawing international scrutiny




December 2007
Feature Story

Anne Paxton

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 two values.

"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 events."

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 patients.

Anne Paxton is a writer in Seattle.

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