engleski

P267 The S2PLIT-UG score, a novel system identifying patients with a high risk of all- cause mortality following acute decompensation of heart failure, correlates with levels of sST2, hs-cTnI and NT-proBNP

Background: The S2PLIT‐UG score has been recently published as a risk stratification tool for 1‐year all‐cause mortality among patients discharged after an acute decompensated heart failure (ADHF) event. This score stratifies ADHF patients into low, intermediate and high‐risk categories. It is calculated by combining 6 variables collected at admission including estimated glomerular filtration rate, uric acid, left ventricular ejection fraction, sodium, systolic blood pressure and the history of heart failure‐ related hospitalizations. The study aimed to determine if patients identified as high‐risk by the S2PLIT‐UG score have higher circulating levels of biomarkers associated with poor prognosis such as soluble suppressor of tumorigenicity 2 (ssT2), high‐ sensitivity cardiac troponin I (hs‐cTnI) and N‐ terminal pro b‐type natriuretic peptide (NT‐ proBNP). A secondary aim was to examine correlations of the S2PLIT‐UG score with the aforementioned biomarkers. Methods: A new validation cohort consisting of 96 patients hospitalized for ADHF and without acute coronary syndrome as an underlying culprit were consecutively included in the study during 2018‐ 2019. All patients underwent standard transthoracic echocardiography, laboratory analyses of peripheral blood, and had their S2PLIT‐UG score calculated with a high‐risk score being defined as having ≥4 points. Results: One‐ quarter of patients (25%, N=24) in analyzed cohort were identified as a high‐risk while 75% of patients (N=72) were non‐high risk according to the S2PLIT‐UG stratification system. Out of those designated as non‐high risk, vast majority were low risk (70.8%, N=51) and 29.2% (N=21) were intermediate risk. High risk group did not significantly differ from non‐high risk group of patients in terms of baseline characteristics including age (p=0.161), body mass index (p=0.437), sex distribution (p=0.637), smoking (p=0.626), dyslipidemia (p=0.898), diabetes mellitus (p=0.286) and presence of atrial fibrillation (p=0.288). Patients identified as high risk had significantly higher circulating levels of ssT2 (65.2±50.2 vs. 34.8±26.4 ng/mL, p<0.001), hs‐ cTnI (142.2±239.0 vs. 42.9±94.0 ng/L, p=0.006), and NT‐proBNP (13199±15325 vs. 5189±7295 pg/mL, p=0.001), compared to patients designated as non‐high risk (Figure 1). As a continuous variable, the S2PLIT‐UG score was in positive and significant correlation with circulating levels of ssT2 (Pearson's r=0.420, p<0.001), hs‐cTnI (r=0.281, p=0.007), and NT‐ proBNP (r=0.344, p=0.001). Conclusions: A present study demonstrated that patients identified as high‐risk according to S2PLIT‐UG score had significantly higher circulating levels of biomarkers associated with poor prognosis, compared to non‐high risk patients while S2PLIT‐UG score correlated positively and significantly with circulating levels of ssT2, hs‐cTnI and NT‐proBNP. These findings suggest a possible complementary value of the S2PLIT‐UG score in the risk stratification of ADHF patients.

S2PLIT-UG score ; inflammation ; adverse ; ventricular remodeling ; fibrosis ; ventricular dysfunction ; LV ; sST2 ; hs-cTnI ; myocardial injury ; troponin ; soluble suppression of tumorigenicity 2 ; NT-proBNP ; natriuretic peptides

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