Yue Zhang, Yunhong Liu, Yuanxia Yang, Lei Peng, Pengyu Zhong, Xiaoxin Jiang
Objective The purpose of this study was to assess whether circulating soluble ST2 independently predicts prognosis in patients with chronic heart failure. Methods This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the unique registration number CRD42023489018. Two researchers systematically searched PubMed, Embase, and Web of Science for all studies published up to 1 September 2024. To evaluate the quality of the study, the Newcastle–Ottawa Scale was used; Review Manager software was used for statistical analysis and construction of forest plots. Results The final analysis comprised 17 studies in total. This meta-analysis demonstrated that a high soluble ST2 level was a predictor of poor all-cause mortality (hazard ratio: 1.03, 95% confidence interval: 1.02–1.04, p < 0.00001), poor all-cause mortality/heart failure-related readmission (hazard ratio: 1.46, 95% confidence interval: 1.33–1.61, p < 0.00001), and higher cardiovascular mortality/heart failure-related hospitalization (hazard ratio: 1.50, 95% confidence interval: 1.30–1.74, p < 0.00001) in patients with chronic heart failure. Subgroup analyses were conducted based on ethnicity, sex, left ventricular ejection fraction, and follow-up duration for both all-cause mortality and all-cause mortality/heart failure-related readmission. Soluble ST2 demonstrated good prognostic value in all subgroups. Conclusion This study, based on current evidence, suggests that soluble ST2 has independent prognostic value in patients with chronic heart failure. The soluble ST2 biomarker performed well in predicting all-cause mortality/heart failure-related readmission and cardiovascular mortality/heart failure-related hospitalization. Further research is needed to validate its role in clinical practice.