5690 COMBINED USE OF SOLUBLE ST2 AND NT-PROBNP FOR PREDICTING MAJOR ADVERSE CARDIOVASCULAR EVENTS IN TYPE 2 DIABETES AND DIVERSE RENAL FUNCTION

Abstract Background and Aims Plasma levels of soluble ST2 protein (sST2), a biomarker associated with fibrosis and inflammation, have been related with an increased risk of adverse events in patients with heart failure (HF) [1,2]; however, data is limited on the prognostic value of sST2 in patients with type 2 diabetes mellitus (T2DM) [3], particularly in association with chronic kidney disease (CKD)4. We aimed to evaluate the impact on cardiovascular (CV) prognosis of sST2 in a population of T2DM with diverse renal function. Method A prospective observational study was conducted in patients with T2DM. Demographic, clinical and analytical data were collected. The main objective was to analyze a composite of combined CV events (major adverse cardiovascular events; MACE) including: CV death, acute myocardial infarction, stroke, coronary revascularization, hospitalization for heart failure, atrial fibrillation, significant valvular heart disease, and hospitalization for any other CV cause). The levels of sST2 and NT-proBNP were analyzed in association with the primary endpoint, as well as with each event separately by survival analysis (log-rank test). Results Ninety-three patients were included with a mean follow-up of 3.5 (3.4-4.2) years. Median sST2 concentrations were 29.8 ng/mL. Table 1 shows the baseline characteristics of patients according to sST2 levels. Univariate analysis showed that higher sST2 levels independently predicted the occurrence of MACE (HR = 2.92; 95% CI: 1.35-6.33) (Figure 1). These results persisted after adjusting for age, sex, and glomerular filtration rate. In addition, a significant interaction was found between sST2 and NT-proBNP, showing a significant relationship between the combination of both biomarkers and the main event (Figure 1). Figure 1: Panel (A): Combined target results of MACE events in patients with sST2 above the median (sST2 ≥ 29,8 ng/ml) (red line), compared with patients with sST2 below the median (blue line). Panel (B): Combined target results of MACE events in patients with NT-proBNP and sST2 below their medians (blue line), patients with only one of the parameters above the median (red line), and patients with both biomarkers above their medians (green line). Table 1: Baseline characteristics of patients according to sST2 levels. Variable Total n = 93 sST2 (29.8 ng/mL) (n = 46) Age, years 66 ± 10.2 67 ± 9.2 65.5 ± 11.4 Females, n (%) 23 (24.5) 11 (12.2) 12 (12.2) BMI, kg/m2 27.9