Relationship between sST2 levels and prognosis in patients with pulmonary arterial hypertension

Aim: Soluble Suppression of Tumorigenicity-2 (sST2) was approved for non-invasive risk assessment and its prognostic benefits were monitored in some heterogeneous pulmonary hypertension cohorts. In this study, we aimed to evaluate the relationship of sST2 use with clinical deterioration and survival in pulmonary arterial hypertension (PAH) patients. Material and Method: Forty-one patients (36 women, 5 men) who were followed due to known PAH were included in the study. The primary endpoint was determined as clinical deterioration. Results: At the end of the mean 6 +/- 2 months follow-up period, in total, 14 patients (34%) exhibited clinical deterioration and 7 patients (17%) died. Patients having WHO-FC III-IV, high sST2, and NT-proBNP levels and low 6-MWT presence were associated with clinical deterioration (p<0.001). Also, sST2 and NT-proBNP levels were significantly higher in patients who died during follow-up (p=0.004 and p=0.003, respectively). In the multivariate Cox proportional hazards model with the forward stepwise method, TAPSE (HR=0.587, 95% CI: 0.419-0.823, p=0.002) and sST2>51 ng/ml on admission (HR=9.653, 95% CI: 4.074-82.249, p=0.004) remained associated with an increased risk of clinical deterioration. Discussion: This study shows that sST2 levels can provide some information in determining clinical impairment in PAH patients. This is compatible with previous studies showing high levels of sST2 in PAH patients. sST2 levels were shown to be an independent predictor of clinical deterioration on PAH.