Abstract
BackgroundAlthough the soluble form of suppression of tumorigenicity 2 (sST2) and soluble low-density lipoprotein receptor relative with 11 ligand-binding repeats (sLR11) have emerged as novel cardiovascular biomarkers in patients with cardiovascular disease, their prognostic value has not been fully investigated in peritoneal dialysis (PD) patients.MethodsWe included 74 prevalent PD patients from a prospective cohort and measured serum sST2 and sLR11 concentrations by an enzyme-linked immunosorbent assay. The association of these biomarkers and all-cause mortality and major adverse cardiac and cerebrovascular events (MACCEs) was evaluated.ResultsDuring a follow-up of 38.5 months, all-cause deaths and MACCEs were observed in 13 (17.6%) patients and 23 (31.3%) patients. Multivariable Cox analyses demonstrated that greater sST2 was independently associated with higher risk of all-cause mortality (≥75.8 ng/mL; hazard ratio [HR] = 5.551; 95% confidence interval [CI] = 1.360–22.660) and MACCEs (≥72.5 ng/mL; HR = 4.609; 95% CI = 1.608–13.208). Furthermore, sST2 showed additive predictive value for mortality to the base model including traditional risk factors (net reclassification index = 0.598, P = 0.04). sLR11 was not significantly associated with all-cause mortality or MACCE.ConclusionssST2, but not sLR11, indicated a significant prognostic value for all-cause mortality and cardiovascular events in PD patients. Further research is needed to validate emerging biomarkers in these populations.
Highlights
The soluble form of suppression of tumorigenicity 2 and soluble low-density lipoprotein receptor relative with 11 ligand-binding repeats have emerged as novel cardiovascular biomarkers in patients with cardiovascular disease, their prognostic value has not been fully investigated in peritoneal dialysis (PD) patients
To compare the predictive value of suppression of tumorigenicity 2 (sST2), sLR11, and high-sensitivity C-reactive protein (hs-CRP) for all-cause mortality and major adverse cardiac and cerebrovascular event (MACCE), we evaluated the additive effects of each biomarker on the base model: model 1, base model + sST2; model 2, base model + sLR11; model 3, base model + hs-CRP
Previous studies indicated that ST2L, the transmembrane receptor form of Suppression of tumorigenicity 2 (ST2), exhibited cardio-protective effects associated with binding to interleukin-33 (IL-33), which results in a reduction in cardiomyocyte apoptosis and fibrosis or hypertrophy of injured cardiac tissues [4, 5]
Summary
The soluble form of suppression of tumorigenicity 2 (sST2) and soluble low-density lipoprotein receptor relative with 11 ligand-binding repeats (sLR11) have emerged as novel cardiovascular biomarkers in patients with cardiovascular disease, their prognostic value has not been fully investigated in peritoneal dialysis (PD) patients. Suppression of tumorigenicity 2 (ST2) is a member of the interleukin 1 receptor family, and its expression is stimulated by myocardial stress and injury [4]. ST2 has two different forms: a cardio-protective transmembrane receptor (ST2L) and a soluble decoy receptor (sST2) [5,6,7]. In patients with coronary artery disease [18, 19], familial hypercholesterolemia [21] and type 2 diabetes [16, 20], sLR11 levels were found to be increased
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