BACKGROUND:Although 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. METHODS:We 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. RESULTS:During 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. CONCLUSIONS:sST2, 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.

译文

背景:尽管抑制致癌性2(sST2)的可溶性形式和相对于11种配体结合重复序列(sLR11)的可溶性低密度脂蛋白受体已成为心血管疾病患者的新型心血管生物标志物,但其预后价值尚未完全在腹膜透析(PD)患者中进行了调查。
方法:我们纳入了来自前瞻性队列的74名流行的PD患者,并通过酶联免疫吸附测定法测量了血清sST2和sLR11的浓度。评估了这些生物标记物与全因死亡率以及主要不良心脏和脑血管事件(MACCE)的关联。
结果:在38.5个月的随访中,观察到13例(17.6%)和23例(31.3%)患者的全因死亡和MACCE。多变量Cox分析表明,更大的sST2与更高的全因死亡率风险(≥75.8ng / mL;危险比[HR] = 5.551; 95%置信区间[CI] = 1.360-22.660)和MACCEs(≥72.5)独立相关ng / mL; HR + = 4.609; 95%CI = 1.608-13.208)。此外,sST2对包括传统危险因素在内的基本模型的死亡率显示出附加的预测价值(净重分类指数= 0.598,P = 0.04)。 sLR11与全因死亡率或MACCE无关。
结论:sST2而非sLR11提示PD患者全因死亡率和心血管事件具有重要的预后价值。需要进一步的研究来验证这些人群中新兴的生物标志物。

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