Abstract | BACKGROUND: Despite the improvement of therapeutic options for patients in acute myocardial infarction (AMI), cardiogenic shock (CS) remains a complication with high mortality rates. Organ failure centrally determines the prognosis of these high-risk patients. Aim of the current study was to assess the incidence of hypoxic hepatitis (HH) in CS, its laboratory detection evaluating novel and established biomarkers and to estimate the prognostic relevance of HH in current clinical practice. METHODS: RESULTS: The overall mortality rate was 40%. The incidence of HH with an increase of aminotransferase levels to be 20 times above the upper normal level was 18%. Patients with HH had a distinctly higher 30-day mortality rate compared to patients without HH (68 vs. 34%; p < 0.001). After multivariable adjustment aspartate-aminotransferase (ASAT) remained an independent predictor of 30-day mortality together with serum lactate and serum creatinine, while the new biomarkers failed to predict outcome. Comparing different liver markers using receiver operating characteristic analysis, ASAT showed the highest area under the curve for the prediction of outcome. CONCLUSIONS: HH occurs frequently in CS and is associated with particular poor outcome. As conventional biomarker, ASAT is the strongest laboratory predictor of outcome. ClinicalTrials.gov Identifier: NCT00491036.
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Authors | Christian Jung, Georg Fuernau, Ingo Eitel, Steffen Desch, Gerhard Schuler, Malte Kelm, Volker Adams, Holger Thiele |
Journal | Clinical research in cardiology : official journal of the German Cardiac Society
(Clin Res Cardiol)
Vol. 106
Issue 5
Pg. 341-349
(May 2017)
ISSN: 1861-0692 [Electronic] Germany |
PMID | 27928583
(Publication Type: Journal Article)
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Topics |
- Aged
- Clinical Laboratory Techniques
(statistics & numerical data)
- Comorbidity
- Enzyme Assays
(statistics & numerical data)
- Female
- Germany
(epidemiology)
- Hepatitis
(blood, diagnosis, mortality)
- Humans
- Incidence
- Ischemia
(diagnosis, mortality)
- Liver
(blood supply)
- Male
- Middle Aged
- Prognosis
- Reproducibility of Results
- Risk Factors
- Sensitivity and Specificity
- Shock, Cardiogenic
(blood, diagnosis, mortality)
- Survival Rate
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