The sST2 level is an independent influencing factor associated with atrial fibrillation in heart failure patients: a case-control study

Background: Most heart failure (HF) patients were complicated with atrial fibrillation (AF). Previous study has reported a correlation between soluble suppression of tumorigenicity 2 (sST2) and HF. While the association between sST2 and AF in HF patients remains elusive, which will strengthen our understanding of sST2 in HF patients.

Methods: In the study, a case-control study was conducted with 306 HF patients enrolled from June 2019 to June 2020 at Beijing Anzhen Hospital. All the patients were divided into the following two groups, based on whether they AF complications prior to admission: (I) the HF group (patients with HF alone) and the HF-AF group (HF patients complicated with AF). Baseline data and sST2 levels were assessed and compared between the two groups, and the influencing factors associated with AF in HF patients were screened.

Results: The sST2 level in the HF-AF group was 40.6 (25.9-53.6) ng/mL, which was significantly higher than that in the HF group [23.7 (16.3-35.9) ng/mL] (P<0.001). Correlation analysis showed that sST2 level in the HF-AF group was positively correlated with age (r=0.287, P=0.001), New York Heart Association (NYHA) grade (r=0.470, P<0.0001), left ventricular diameter (LVD) (r=0.311, P=0.001), serum creatinine (r=0.320, P<0.0001), NT-pro-brain natriuretic peptide (r=0.540, P<0.0001), and D-dimer (r=0.322, P<0.0001), and negatively correlated with left ventricular ejection fraction (LVEF) (r=-0.259, P=0.004), hemoglobin (r=-0.188, P=0.039), and glomerular filtration rate (r=-0.283, P=0.002). Logistic regression analysis results indicated that history of coronary heart disease [odds ratio (OR): 0.176, 95% confidence interval (CI): 0.081-0.380, P<0.0001], LVEF (OR: 0.956, 95% CI: 0.915-0.998, P=0.039), LVD (OR: 1.156, 95% CI: 1.059-1.261, P=0.001), left arterial diameter (OR: 0.761, 95% CI: 0.695-0.833, P<0.0001), and sST2 (OR: 0.942, 95% CI: 0.917-0.967, P<0.0001) were independent influencing factors associated with AF in HF patients.

Conclusions: The sST2 level is an independent influencing factor associated with AF in HF patients, which may favor to optimize the clinical strategies in the management of HF patients complicated with AF.