Soluble ST2 proteins in male cachectic patients with chronic heart failure

Nutr Metab Cardiovasc Dis. 2021 Mar 10;31(3):886-893. doi: 10.1016/j.numecd.2020.11.014. Epub 2020 Nov 21.


Background and aims: Until now, there are lack of established clinical factors allowing management of chronic heart failure (CHF) patients being at risk of cardiac cachexia (CC). The changes in soluble protein ST2 (sST2) concentrations suggest a valuable and prognostic usefulness of this biomarker in monitoring patients with CHF, especially those who potentially are prompt to develop CC. The aim of this study was to assess the potential role of sST2 in male patients with CHF under cachexia condition.

Methods and result: 91 male patients were selected to the study group and underwent meticulous screening according to recent clinical guidelines in order to CHF and CC detection. Additionally all patients underwent assessment of body composition and sST2 testing. Patients were followed-up for 60 months. Plasma sST2 concentration was significantly increased in cachectic compared with non-cachectic patients (median: 27.40 ng/mL and 20.62 ng/mL; p < 0.001), however, in this group the EF% was reduced (mean: 34 ± 13.5% and 41 ± 14.5%; p = 0.029). Correlations between sST2 and CRP (R = 0.524; p < 0.001) and phase angle (PA) (R = -0.513; p < 0.001) were observed. CHF patients in whose the PA value ranged in Q1 (<3.06°) and sST2 concentration ranged in Q3 (>33.15 ng/mL) had higher risk of death (HR = 9.62 and 8.60, respectively). The death rate was the highest in cachectic group with the simultaneous presence of sST2-Q3 and PA-Q1 (87.5% of this group). They had almost 7-fold higher risk of death during follow-up period (HR = 6.89, p < 0.001).

Conclusions: sST2 demonstrates potential utility in male patients with CHF under cachexia condition in prediction death rate.

Keywords: Bioelectrical impedance analysis; Cachexia; Chronic heart failure; sST2.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Body Composition
  • Cachexia / blood*
  • Cachexia / diagnosis
  • Cachexia / mortality
  • Cachexia / physiopathology
  • Chronic Disease
  • Heart Failure / blood*
  • Heart Failure / diagnosis
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Humans
  • Interleukin-1 Receptor-Like 1 Protein / blood*
  • Male
  • Middle Aged
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Time Factors


  • Biomarkers
  • IL1RL1 protein, human
  • Interleukin-1 Receptor-Like 1 Protein