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Prognostic value of soluble ST2 in AL and TTR cardiac amyloidosis: a multicenter study

BACKGROUND: Both light-chain (AL) amyloidosis and transthyretin (ATTR) amyloidosis are types of cardiac amyloidosis (CA) that require accurate prognostic stratification to plan therapeutic strategies and follow-ups. Cardiac biomarkers, e.g., N-terminal pro-B-type natriuretic peptide (NT-proBNP) and...

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Autores principales: Nicol, Martin, Vergaro, Giuseppe, Damy, Thibaud, Kharoubi, Mounira, Baudet, Mathilde, Canuti, Elena Sofia, Aimo, Alberto, Castiglione, Vincenzo, Emdin, Michele, Royer, Bruno, Harel, Stephanie, Cohen-Solal, Alain, Arnulf, Bertrand, Logeart, Damien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10433216/
https://www.ncbi.nlm.nih.gov/pubmed/37600055
http://dx.doi.org/10.3389/fcvm.2023.1179968
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author Nicol, Martin
Vergaro, Giuseppe
Damy, Thibaud
Kharoubi, Mounira
Baudet, Mathilde
Canuti, Elena Sofia
Aimo, Alberto
Castiglione, Vincenzo
Emdin, Michele
Royer, Bruno
Harel, Stephanie
Cohen-Solal, Alain
Arnulf, Bertrand
Logeart, Damien
author_facet Nicol, Martin
Vergaro, Giuseppe
Damy, Thibaud
Kharoubi, Mounira
Baudet, Mathilde
Canuti, Elena Sofia
Aimo, Alberto
Castiglione, Vincenzo
Emdin, Michele
Royer, Bruno
Harel, Stephanie
Cohen-Solal, Alain
Arnulf, Bertrand
Logeart, Damien
author_sort Nicol, Martin
collection PubMed
description BACKGROUND: Both light-chain (AL) amyloidosis and transthyretin (ATTR) amyloidosis are types of cardiac amyloidosis (CA) that require accurate prognostic stratification to plan therapeutic strategies and follow-ups. Cardiac biomarkers, e.g., N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (Hs-cTnT), remain the cornerstone of the prognostic assessment. An increased level of soluble suppression of tumorigenesis-2 (sST2) is predictive of adverse events [all-cause death and heart failure (HF) hospitalizations] in patients with HF. This study aimed to evaluate the prognostic value of circulating sST2 levels in AL-CA and ATTR-CA. METHODS: We carried out a multicenter study including 133 patients with AL-CA and 152 patients with ATTR-CA. During an elective outpatient visit for the diagnosis of CA, Mayo Clinic staging [NT-proBNP, Hs-cTnT, differential of free light chains (DFLCs)] and sST2 were assessed for all AL patients. Gillmore staging [including estimated glomerular filtration rate (eGFR), NT-proBNP] and Grogan staging (including NT-proBNP and Hs-cTnT) were assessed for TTR-CA patients. RESULTS: The median age was 73 years [interquartile range (IQR) 61–81], and 53% were men. The endpoint was the composite of all-cause death or first HF-related hospitalization. The median follow-up was 20 months (IQR 3–34) in AL amyloidosis and 33 months (6–45) in TTR amyloidosis. The primary outcome occurred in 70 (53%) and 99 (65%) of AL and TTR patients, respectively. sST2 levels were higher in patients with AL-CA than in patients with ATTR-CA: 39 ng/L (26–80) vs. 32 ng/L (21–46), p < 0.001. In AL-CA, sST2 levels predicted the outcome regardless of the Mayo Clinic score (HR: 2.16, 95% CI: 1.17–3.99, p < 0.001). In TTR-CA, sST2 was not predictive of the outcome in multivariate models, including Gillmore staging and Grogan staging (HR: 1.17, CI: 95% 0.77–1.89, p = 0.55). CONCLUSION: sST2 level is a relevant predictor of death and HF hospitalization in AL cardiac amyloidosis and adds prognostic stratification on top of NT-proBNP, Hs cTnT, and DFLC.
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spelling pubmed-104332162023-08-18 Prognostic value of soluble ST2 in AL and TTR cardiac amyloidosis: a multicenter study Nicol, Martin Vergaro, Giuseppe Damy, Thibaud Kharoubi, Mounira Baudet, Mathilde Canuti, Elena Sofia Aimo, Alberto Castiglione, Vincenzo Emdin, Michele Royer, Bruno Harel, Stephanie Cohen-Solal, Alain Arnulf, Bertrand Logeart, Damien Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Both light-chain (AL) amyloidosis and transthyretin (ATTR) amyloidosis are types of cardiac amyloidosis (CA) that require accurate prognostic stratification to plan therapeutic strategies and follow-ups. Cardiac biomarkers, e.g., N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (Hs-cTnT), remain the cornerstone of the prognostic assessment. An increased level of soluble suppression of tumorigenesis-2 (sST2) is predictive of adverse events [all-cause death and heart failure (HF) hospitalizations] in patients with HF. This study aimed to evaluate the prognostic value of circulating sST2 levels in AL-CA and ATTR-CA. METHODS: We carried out a multicenter study including 133 patients with AL-CA and 152 patients with ATTR-CA. During an elective outpatient visit for the diagnosis of CA, Mayo Clinic staging [NT-proBNP, Hs-cTnT, differential of free light chains (DFLCs)] and sST2 were assessed for all AL patients. Gillmore staging [including estimated glomerular filtration rate (eGFR), NT-proBNP] and Grogan staging (including NT-proBNP and Hs-cTnT) were assessed for TTR-CA patients. RESULTS: The median age was 73 years [interquartile range (IQR) 61–81], and 53% were men. The endpoint was the composite of all-cause death or first HF-related hospitalization. The median follow-up was 20 months (IQR 3–34) in AL amyloidosis and 33 months (6–45) in TTR amyloidosis. The primary outcome occurred in 70 (53%) and 99 (65%) of AL and TTR patients, respectively. sST2 levels were higher in patients with AL-CA than in patients with ATTR-CA: 39 ng/L (26–80) vs. 32 ng/L (21–46), p < 0.001. In AL-CA, sST2 levels predicted the outcome regardless of the Mayo Clinic score (HR: 2.16, 95% CI: 1.17–3.99, p < 0.001). In TTR-CA, sST2 was not predictive of the outcome in multivariate models, including Gillmore staging and Grogan staging (HR: 1.17, CI: 95% 0.77–1.89, p = 0.55). CONCLUSION: sST2 level is a relevant predictor of death and HF hospitalization in AL cardiac amyloidosis and adds prognostic stratification on top of NT-proBNP, Hs cTnT, and DFLC. Frontiers Media S.A. 2023-08-02 /pmc/articles/PMC10433216/ /pubmed/37600055 http://dx.doi.org/10.3389/fcvm.2023.1179968 Text en © 2023 Nicol, Vergaro, Damy, Kharoubi, Baudet, Canuti, Aimo, Castiglione, Emdin, Royer, Harel, Cohen-Solal, Arnulf and Logeart. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Nicol, Martin
Vergaro, Giuseppe
Damy, Thibaud
Kharoubi, Mounira
Baudet, Mathilde
Canuti, Elena Sofia
Aimo, Alberto
Castiglione, Vincenzo
Emdin, Michele
Royer, Bruno
Harel, Stephanie
Cohen-Solal, Alain
Arnulf, Bertrand
Logeart, Damien
Prognostic value of soluble ST2 in AL and TTR cardiac amyloidosis: a multicenter study
title Prognostic value of soluble ST2 in AL and TTR cardiac amyloidosis: a multicenter study
title_full Prognostic value of soluble ST2 in AL and TTR cardiac amyloidosis: a multicenter study
title_fullStr Prognostic value of soluble ST2 in AL and TTR cardiac amyloidosis: a multicenter study
title_full_unstemmed Prognostic value of soluble ST2 in AL and TTR cardiac amyloidosis: a multicenter study
title_short Prognostic value of soluble ST2 in AL and TTR cardiac amyloidosis: a multicenter study
title_sort prognostic value of soluble st2 in al and ttr cardiac amyloidosis: a multicenter study
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10433216/
https://www.ncbi.nlm.nih.gov/pubmed/37600055
http://dx.doi.org/10.3389/fcvm.2023.1179968
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