Association of the biomarkers soluble ST2, galectin-3 and growth-differentiation factor-15 with heart failure and other non-cardiac diseases

Background: The biomarkers soluble ST2 (5ST2), galectin-3, and growth-differentiation factor-15 (GDF-15) provide prognostic information in patients with heart failure (HF). The aim of this study was to evaluate to which extent plasma concentrations of these biomarkers are increased in HF compared with diverse non-cardiac conditions such as infectious disease or chronic kidney disease. Methods: We recruited 15 patients in each of the following clinical categories: HF without co-morbidity, pneumonia without co-morbidity, chronic obstructive pulmonary disease (COPD) without co-morbidity, HF and a co-morbidity of pneumonia, renal disease without co-morbidity, and sepsis. We used 22 healthy individuals as control group. In each of the 112 study participants, we measured plasma concentrations of sST2 (Presage assay), galecfin-3 (Abbott assay) and GDF-15 (Roche assay). Results: Compared to controls, the median sST2 concentration was similar to 2.5-fold increased in HF, similar to 3.5-fold in pneumonia, similar to 5.0-fold in COPD, similar to 5.8-fold in HF + pneumonia, and similar to 70-fold in sepsis (p < 0.001 for all). sST2 was not significantly increased in renal disease. Compared to controls, the median galectin-3 concentration was similar to 1.5-fold increased in HF, similar to 1.4-fold in pneumonia, similar to 2.4-fold in HF + pneumonia, similar to 25-fold in renal disease, and similar to 2.7-fold in sepsis (p < 0.001 for all). Galectin-3 was not significantly increased in COPD. Compared to controls, the median GDF-15 concentration was similar to 4.4-fold increased in HF, similar to 5.4-fold in pneumonia, similar to 2.1-fold in COPD, similar to 83-fold in HF + pneumonia, similar to 5.1-fold in renal disease, and similar to 27-fold in sepsis (p < 0.001). In the 112 study participants, correlation analyses revealed a relatively strong association between galectin-3 and GDF-15 (correlation coefficient, 0.739; p < 0.001). Conclusion: Because increased plasma concentrations of sST2, galectin-3, and GDF-15 are not specific for a distinct disease group, the three biomarkers are not useful for diagnostic purposes. The results of our study are novel with respect to sST2, galectin-3 and GDF-15 as markers of inflammatory diseases and should encourage further studies. (C) 2015 The Authors. Published by Elsevier B.V.