Prognostic value of serum soluble suppression of tumorigenicity 2, galectin-3 and growth differentiation factor-15 in patients hospitalized with heart failure

Objective To explore the prognostic value of serum soluble suppression of tumorigenicity 2 (sST2), galectin-3 (Gal-3) and growth differentiation factor-15 (GDF-15) in patients hospitalized with heart failure (HF). Methods Patients hospitalized with HF in Anhui Provincial Hospital from May 2018 to August 2018 were prospectively enrolled and divided into event group and non-event group based on the occurrence of endpoint events (cardiovascular death or readmission due to HF) within 1 year follow-up after discharge and levels of sST2, Gal-3, GDF-15 on admission were compared. The prognostic values of sST2, Gal-3 and GDF-15 alone and combined with N-terminal pro B type natriuretic peptide (NT-proBNP) were evaluated by the area under the receiver operating characteristic (ROC) curve (AUC) and multivariate Cox regression model was used to determine the risk factors for endpoint events. Results A total of 80 patients were enrolled and 39 had events. The levels of sST2, Gal-3, GDF-15 and NT-proBNP in the event group were significantly higher than those in the event-free group (all P 0.05). ROC curve showed that AUC of sST2, Gal-3 and GDF-15 alone for events was 0.924, 0.894 and 0.768 respectively, which were lower than that (0.946) of NT-proBNP (all P 0.05). There was a significant increase in AUC from 0.946 for NT-proBNP alone to 0.972 for the three biomarkers combined with NT-proBNP (P<0.05). Multivariate Cox regression analysis showed that NT-proBNP [lg NT-proBNP, hazard ratio (HR) 4.249, 95% confidence interval (CI) 1.606-11.243, P<0.01] and sST (HR 1.018, 95%CI 1.004-1.033, P<0.05) were independent risk factors for events within 1-year follow-up after discharge. Conclusion Serum sST2, Gal-3 and GDF15 as novel biomarkers have certain prognostic value in patients hospitalized with HF. Combination of the three biomarkers and traditional marker NT-proBNP can improve the prognosis. Key words: Biomarker, novel; Soluble suppression of tumorigenicity 2; Galectin-3; Growth differentiation factor-15; Heart failure