Biomarkers in heart failure: ST2

Abstract

Biomarkers have emerged as indispensable tools for diagnosis and prognosis in a variety of cardiovascular diseases, and several are now considered standard of care. New markers are constantly being developed, but very few are able to signifi- cantly improve upon already-established markers. ST2 is a marker of cardiomyocyte stress and fibrosis which provides incremental value to natriuretic peptides for risk stratification in heart failure. Based upon the totality of data, measurement of ST2 is now recommended for additive risk stratification in patients with acute or ambulatory heart failure in the 2013 ACCF/AHA Guidelines. Looking forward, ST2 levels may be useful for tailoring medical therapy and to predict ventricular reverse remodeling. This chapter provides an up-to-date overview of ST2 as a marker of heart failure, and provides illustrative clinical cases into the application of ST2 now and in the future.