Soluble ST2 as a biomarker in heart failure

Soluble ST2 as a biomarker in heart failure

Soluble ST2: ST2 (suppression of tumorigenicity 2) region on chromosome 11 is a locus associated with various forms of cancer. IL1R1 on chromosome 2 has the alias ST2 and encodes a member of the interleukin 1 receptor family [1]. These two are often confused with each other in published literature.

Soluble form of ST2 (sST2) is a novel biomarker for cardiac risk prediction, which is secreted into the circulation. It has been used in the management of heart failure as a therapy guide[2]. The other variant is transmembrane ST2 isoform known as ST2L [3].

ST2 is an interleukin-1 receptor family biomarker. Interleukin-1 like cytokine is secreted in response to cell damage. Circulating sST2 concentrations reflect myocardial stress and myocardial fibrosis [4].

sST2 values have been positively correlated with the severity of acute heart failure, B-type natriuretic peptide and C-reactive protein, and negatively correlated with ejection fraction and creatinine clearance [5]. sST2 when used in combination with NT-proBNP (N-terminal pro-B–type natriuretic peptide) is useful in assessing prognosis in chronic heart failure beyond clinical risk scores [6].


  1. ST2 suppression of tumorigenicity 2 [Homo sapiens (human)]. Gene ID: 6761, updated on 30-Jul-2016. Available at:
  2. Quick S, Waessnig NK, Kandler N, Poitz DM, Schoen S, Ibrahim K, Strasser RH, Speiser U. Soluble ST2 and myocardial fibrosis in 3T cardiac magnetic resonance. Scand Cardiovasc J. 2015;49(6):361-6.
  3. Díez J. Serum soluble ST2 as a biochemical marker of acute heart failure: future areas of research. J Am Coll Cardiol. 2008 Oct 28;52(18):1466-7.
  4. Humberto Villacorta, Alan S Maisel. Soluble ST2 Testing: A Promising Biomarker in the Management of Heart Failure. Arq Bras Cardiol. 2016 Feb;106(2):145-52.
  5. Rehman SU, Mueller T, Januzzi JL Jr. Characteristics of the novel interleukin family biomarker ST2 in patients with acute heart failure. J Am Coll Cardiol. 2008 Oct 28;52(18):1458-65.
  6. Ky B, French B, McCloskey K, Rame JE, McIntosh E, Shahi P, Dries DL, Tang WH, Wu AH, Fang JC, Boxer R, Sweitzer NK, Levy WC, Goldberg LR, Jessup M, Cappola TP. High-sensitivity ST2 for prediction of adverse outcomes in chronic heart failure. Circ Heart Fail. 2011 Mar;4(2):180-7.
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