A novel cardiac biomarker, ST2, will be highlighted in three presentations at the American College of Cardiology (ACC) in New Orleans this week. These studies and others have demonstrated that a patient's ST2 level can help a physician better predict prognosis, change in cardiac status, and development of cardiovascular complications such as heart failure, at critical clinical decision points, including at initial presentation with chest pain, after recovery from myocardial infarction, and in the cardiac intensive care unit.

"We continue to find that ST2 is a valuable prognostic tool in assessing patients across various stages of cardiovascular disease," said Dr. James L. Januzzi, the Director of the Cardiac Intensive Care Unit at Massachusetts General Hospital and Associate Professor of Medicine at Harvard Medical School. "In our recent study in Advanced Stage Heart Failure Patients, we concluded that measurement of ST2 may help us determine appropriate courses of action in these late-stage patients."

The studies and findings to be presented at ACC 2011 are:

- Measurement of Soluble ST2 in Advanced Stage Heart Failure Patients Treated with Invasive Hemodynamic "Tailored" Therapy. Zilinski, J et al. ACC Poster 1054.

Key Findings: In this study of 30 patients with American Heart Association Stage D Heart Failure (HF) undergoing therapy guided by invasive monitoring, elevated concentrations of ST2 were associated with failed achievement of filling pressure goals, and predict impending death, LVAD (Left Ventricular Assist Device) placement or heart transplantation. An ST2 >104 ng/mL predicted mortality, LVAD, or heart transplant within 90 days (Hazard Ratio = 5.5; p =.03). The investigators concluded that measurement of ST2 may be useful to assist in care decisions in advanced stage HF patients.

- ST2 Predicts Heart Failure and All Cause Mortality in Patients Presenting to the Emergency Department with Chest Pain. Aldous, S et al. ACC Poster 1071.

Key Findings: In this study of 995 patients, ST2 conveyed risk of death and heart failure in patients presenting to the Emergency Department with chest pain. After adjustment for other biomarkers including BNP, the Hazard Ratio for risk of death or developing heart failure was still high at 3.1 (p < .001).

- Echocardiographic Structure and Functional Correlates of ST2 and Brain Naturietic Peptide Levels in Patients with Acute Myocardial Infarction. Kontos, MC et al. ACC Poster 1106.

Key Findings: In 140 clinically stable patients diagnosed with myocardial infarction (MI), the investigators used echocardiography to measure the heart's function as well as the biomarkers, BNP and ST2. Both elevated ST2 and BNP were associated with clinical and echocardiographic findings indicative of increased filling pressures/myocardial stretch. The absence of elevations in both markers identified patients with low risk clinical and echocardiographic variables. The investigators concluded that increased ST2 and BNP levels identify post MI patients who have clinical and echocardiographic variables associated with worse prognosis.

"We are pleased to see the research community continue to generate strong evidence that ST2 predicts outcomes for cardiovascular patients," said James Snider, President of Critical Diagnostics. "The studies presented here show that ST2 can be a valuable tool for clinicians across the spectrum of heart failure: from predicting onset to predicting outcomes in late-stage patients. These clinical data continue to build evidence that ST2 may help aid physicians in clinical decision-making."

About Critical Diagnostics and ST2

Critical Diagnostics develops products to help physicians optimize patient care in cardiovascular diseases, such as heart failure. Our highly sensitive Presage ST2 Assay measures the level of ST2 in blood, identifying patients at increased risk of morbidity and mortality. ST2 has been evaluated in over 50 peer-reviewed publications, now spanning more than 25,000 subjects.

ST2 signals the presence of adverse cardiac remodeling and fibrosis, which occurs in response to myocardial infarction (MI), ischemia, or worsening heart failure. Remodeling and fibrosis can also contribute to the development of future adverse events, such as secondary MI or sudden cardiac death (SCD), and to progression of heart failure.

The Presage ST2 Assay helps clinicians assess patient prognosis in order to better personalize their care. By selecting the most appropriate treatments and interventions for each patient, a physician can maximize the clinical benefit from increasingly limited healthcare resources.

The Presage ST2 Assay is not available for sale in the USA, pending FDA clearance.

References

1. Jodi L. Zilinski, Ravi V. Shah, Linda Barajas, Justine A. Barajas, Thomas J. Wang, James L. Januzzi, Massachusetts General Hospital, Boston, MA Measurement of Soluble ST2 in Advanced Stage Heart Failure Patients Treated with Invasive Hemodynamic "Tailored" Therapy. ACC Poster Contributions 1054.

2. Sally Aldous, Martin Than, Mark Richards, Christchurch Hospital, Christchurch, New Zealand. ST2 Predicts Heart Failure and All Cause Mortality in Patients Presenting to the Emergency Department with Chest Pain. ACC Poster Contributions 1071.

3. Michael C. Kontos, Xiaoyan Gu, Yihua He, Anthony Haney, Christine Urbas, Catherine Guard, J.V. Nixon, Virginia Commonwealth University, Richmond, VA Echocardiographic Structure and Functional Correlates of ST2 and Brain Naturietic Peptide Levels in Patients with Acute Myocardial Infarction. ACC Poster Contributions 1106.

Source:
Critical Diagnostics