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Prognostic value of soluble ST2 postaortic valve replacement: a meta-analysis
  1. Gary Tse1,2,
  2. Christina Ip1,2,
  3. King Sum Luk1,2,
  4. Mengqi Gong3,
  5. Yan Yee Ting1,2,
  6. Ishan Lakhani1,2,
  7. George Bazoukis4,
  8. Guangping Li3,
  9. Konstantinos P Letsas4,
  10. Mei Dong5,
  11. Tong Liu3,
  12. Martin C S Wong6
  1. 1 Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
  2. 2 Faculty of Medicine, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China
  3. 3 Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
  4. 4 Laboratory of Cardiac Electrophysiology, Second Department of Cardiology, ‘Evangelismos’ General Hospital of Athens, Athens, Greece
  5. 5 Department of Cardiology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, China
  6. 6 JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
  1. Correspondence to Dr Gary Tse, Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China; tseg{at}cuhk.edu.hk and Professor Martin C S Wong, JC School of Public Health and Primary Care The Chinese University of Hong Kong Hong Kong China ; wong_martin{at}cuhk.edu.hk

Abstract

Objectives Soluble suppression of tumorigenicity 2 (sST2) is a member of the interleukin-1 receptor family and a modulator of hypertrophic and fibrotic responses. Its prognostic value for patients undergoing aortic valve replacement (AVR) has been examined in prospective studies but to date, there has been no systematic evaluation or meta-analysis on this issue.

Methods PubMed and Embase were searched until 1 October 2017 for studies that evaluated the relationship between sST2 levels and mortality after AVR.

Results A total of 18 and 37 entries were retrieved from both databases, from which four studies were included in the final meta-analysis. In a total of 1154 subjects (50% male, mean age 80±10 years old, mean follow-up 14 months), elevated sST2 levels were significantly associated with a 44% increase in the risk of all-cause mortality (HR 1.44, 95% CI 1.30 to 1.60, p<0.0001; I2: 44%).

Conclusions sST2 significantly predicts all-cause mortality in patients who have undergone AVR, but this conclusion is limited by the small number of patients. Larger prospective studies are required to better elucidate its value for risk stratification in this patient population.

  • aortic valve disease
  • risk stratification
  • epidemiology

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Footnotes

  • Contributors GT: data extraction, analysis, manuscript draft and critical revision. MG: data analysis, manuscript critical revision. CI, KSL, YYT, IL, GB, GL, KPL, MD: data interpretation, critical revision of manuscript. TL, MCSW: conception of study, data interpretation, critical revision of manuscript.

  • Funding This study was funded by the Croucher Foundation of Hong Kong (10.13039/501100001692).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.