Prognosis of cardiovascular events after implantation of a cardioverterdefibrillator in patients with chronic heart failure: the value of increasing concentration of endothelin-1 and soluble forms of ST2 protein in blood plasma

Aim. The purpose of this study was to examine the association of increasing concentrations of endothelin-1 and soluble forms of ST2 protein (sST2)  in the blood plasma of patients with chronic heart failure (CHF) who underwent implantation of a cardioverter-defibrillator, with the development of car...

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Main Authors: A. T. Teplyakov, N. I. Tarasov, L. K. Isakov, E. V. Grakova, M. N. Sinkova, K. V. Kopieva, О. B. Garmaeva, O. N. Ogurkova, V. V. Kalyuzhin, E. V. Kalyuzhina
Format: Article
Language:English
Published: Siberian State Medical University (Tomsk) 2018-09-01
Series:Бюллетень сибирской медицины
Subjects:
Online Access:https://bulletin.ssmu.ru/jour/article/view/1293
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author A. T. Teplyakov
N. I. Tarasov
L. K. Isakov
E. V. Grakova
M. N. Sinkova
K. V. Kopieva
О. B. Garmaeva
O. N. Ogurkova
V. V. Kalyuzhin
E. V. Kalyuzhina
author_facet A. T. Teplyakov
N. I. Tarasov
L. K. Isakov
E. V. Grakova
M. N. Sinkova
K. V. Kopieva
О. B. Garmaeva
O. N. Ogurkova
V. V. Kalyuzhin
E. V. Kalyuzhina
author_sort A. T. Teplyakov
collection DOAJ
description Aim. The purpose of this study was to examine the association of increasing concentrations of endothelin-1 and soluble forms of ST2 protein (sST2)  in the blood plasma of patients with chronic heart failure (CHF) who underwent implantation of a cardioverter-defibrillator, with the development of cardiovascular events (death from cardiovascular diseases, decompensated CHF, acute coronary syndrome or acute ischemic stroke) to determine whether these biomarkers can be used as predictors of an unfavorable course of the disease.Material and methods. A 6-month cohort study included 40 patients with CHF who received an ICD 4-12 weeks before their inclusion in the study. At the beginning of the study the concentrations of endothelin-1 and sST2 in plasma by ELISA were analyzed, along with conventional diagnostic techniques typical of a specialized cardiology clinic.Results. Phenotype with a favorable course of the disease was identified in 21 patients (group 1), and with a unfavorable course was seen in 19 (group 2). The concentration of endothelin-1 and sST2 in the blood plasma of the 2nd group patients was higher than in patients of the 1st group. The link of cardiovascular events with high levels of soluble ST2 protein and endothelin-1 in blood plasma has been identified. Variation of the decision rule threshold on the ROC-curve has allowed sST2 concentration of 34.93 ng/ml to be determined as a cutoff  point.  Accuracy of two-class classification (determination of  the posterior probability of cardiovascular events) after identifying such cut-off  point was characterized by 93%  sensitivity and 72% specificity (area under ROC-curve – 0.87).  If the value of the plasma concentrations of sST2 more 34.93 ng/ml the relative risk of cardiovascular events was 4.4 (95% CI 1.7–11.1). The use of endothelin-1 surplus in plasma (cut-off point – 0.34 fmol/ml) in predicting cardiovascular events was lower: the sensitivity – 88%, specificity – 68% (area under ROC-curve – 0.74). When the concentration of endothelin-1 in blood plasma was more than 0.34 fmol/ml the relative risk of cardiovascular events was 2.7 (95% CI 1.2–6.3).Conclusion. The increase in the sST2 and endothelin-1 concentration in blood plasma may be considered as a predictor of cardiovascular events in CHF patients after implantation of cardioverter-defibrillator.
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spelling doaj.art-07e5463310614dc8a92c1f489d4c33d32023-03-13T09:58:24ZengSiberian State Medical University (Tomsk)Бюллетень сибирской медицины1682-03631819-36842018-09-0117314015010.20538/1682-0363-2018-3-140-150817Prognosis of cardiovascular events after implantation of a cardioverterdefibrillator in patients with chronic heart failure: the value of increasing concentration of endothelin-1 and soluble forms of ST2 protein in blood plasmaA. T. Teplyakov0N. I. Tarasov1L. K. Isakov2E. V. Grakova3M. N. Sinkova4K. V. Kopieva5О. B. Garmaeva6O. N. Ogurkova7V. V. Kalyuzhin8E. V. Kalyuzhina9Научно-исследовательский институт (НИИ) кардиологии, Томский национальный исследовательский медицинскийй центр (ТНИМЦ) Российской академии наук (РАН)Кемеровский государственный медицинский университет (КемГМУ)Кемеровский государственный медицинский университет (КемГМУ)Научно-исследовательский институт (НИИ) кардиологии, Томский национальный исследовательский медицинскийй центр (ТНИМЦ) Российской академии наук (РАН)Кемеровский государственный медицинский университет (КемГМУ)Научно-исследовательский институт (НИИ) кардиологии, Томский национальный исследовательский медицинскийй центр (ТНИМЦ) Российской академии наук (РАН)Научно-исследовательский институт (НИИ) кардиологии, Томский национальный исследовательский медицинскийй центр (ТНИМЦ) Российской академии наук (РАН)Научно-исследовательский институт (НИИ) кардиологии, Томский национальный исследовательский медицинскийй центр (ТНИМЦ) Российской академии наук (РАН)Сибирский государственный медицинский университет (СибГМУ)Сибирский государственный медицинский университет (СибГМУ)Aim. The purpose of this study was to examine the association of increasing concentrations of endothelin-1 and soluble forms of ST2 protein (sST2)  in the blood plasma of patients with chronic heart failure (CHF) who underwent implantation of a cardioverter-defibrillator, with the development of cardiovascular events (death from cardiovascular diseases, decompensated CHF, acute coronary syndrome or acute ischemic stroke) to determine whether these biomarkers can be used as predictors of an unfavorable course of the disease.Material and methods. A 6-month cohort study included 40 patients with CHF who received an ICD 4-12 weeks before their inclusion in the study. At the beginning of the study the concentrations of endothelin-1 and sST2 in plasma by ELISA were analyzed, along with conventional diagnostic techniques typical of a specialized cardiology clinic.Results. Phenotype with a favorable course of the disease was identified in 21 patients (group 1), and with a unfavorable course was seen in 19 (group 2). The concentration of endothelin-1 and sST2 in the blood plasma of the 2nd group patients was higher than in patients of the 1st group. The link of cardiovascular events with high levels of soluble ST2 protein and endothelin-1 in blood plasma has been identified. Variation of the decision rule threshold on the ROC-curve has allowed sST2 concentration of 34.93 ng/ml to be determined as a cutoff  point.  Accuracy of two-class classification (determination of  the posterior probability of cardiovascular events) after identifying such cut-off  point was characterized by 93%  sensitivity and 72% specificity (area under ROC-curve – 0.87).  If the value of the plasma concentrations of sST2 more 34.93 ng/ml the relative risk of cardiovascular events was 4.4 (95% CI 1.7–11.1). The use of endothelin-1 surplus in plasma (cut-off point – 0.34 fmol/ml) in predicting cardiovascular events was lower: the sensitivity – 88%, specificity – 68% (area under ROC-curve – 0.74). When the concentration of endothelin-1 in blood plasma was more than 0.34 fmol/ml the relative risk of cardiovascular events was 2.7 (95% CI 1.2–6.3).Conclusion. The increase in the sST2 and endothelin-1 concentration in blood plasma may be considered as a predictor of cardiovascular events in CHF patients after implantation of cardioverter-defibrillator.https://bulletin.ssmu.ru/jour/article/view/1293хроническая сердечная недостаточностьимплантируемый кардиовертер-дефибрилляторсердечно-сосудистые событияпрогнозбиомаркерыэндотелин-1растворимая форма белка st2
spellingShingle A. T. Teplyakov
N. I. Tarasov
L. K. Isakov
E. V. Grakova
M. N. Sinkova
K. V. Kopieva
О. B. Garmaeva
O. N. Ogurkova
V. V. Kalyuzhin
E. V. Kalyuzhina
Prognosis of cardiovascular events after implantation of a cardioverterdefibrillator in patients with chronic heart failure: the value of increasing concentration of endothelin-1 and soluble forms of ST2 protein in blood plasma
Бюллетень сибирской медицины
хроническая сердечная недостаточность
имплантируемый кардиовертер-дефибриллятор
сердечно-сосудистые события
прогноз
биомаркеры
эндотелин-1
растворимая форма белка st2
title Prognosis of cardiovascular events after implantation of a cardioverterdefibrillator in patients with chronic heart failure: the value of increasing concentration of endothelin-1 and soluble forms of ST2 protein in blood plasma
title_full Prognosis of cardiovascular events after implantation of a cardioverterdefibrillator in patients with chronic heart failure: the value of increasing concentration of endothelin-1 and soluble forms of ST2 protein in blood plasma
title_fullStr Prognosis of cardiovascular events after implantation of a cardioverterdefibrillator in patients with chronic heart failure: the value of increasing concentration of endothelin-1 and soluble forms of ST2 protein in blood plasma
title_full_unstemmed Prognosis of cardiovascular events after implantation of a cardioverterdefibrillator in patients with chronic heart failure: the value of increasing concentration of endothelin-1 and soluble forms of ST2 protein in blood plasma
title_short Prognosis of cardiovascular events after implantation of a cardioverterdefibrillator in patients with chronic heart failure: the value of increasing concentration of endothelin-1 and soluble forms of ST2 protein in blood plasma
title_sort prognosis of cardiovascular events after implantation of a cardioverterdefibrillator in patients with chronic heart failure the value of increasing concentration of endothelin 1 and soluble forms of st2 protein in blood plasma
topic хроническая сердечная недостаточность
имплантируемый кардиовертер-дефибриллятор
сердечно-сосудистые события
прогноз
биомаркеры
эндотелин-1
растворимая форма белка st2
url https://bulletin.ssmu.ru/jour/article/view/1293
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