Mortality in cardiogenic shock is stronger associated to clinical factors than contemporary biomarkers reflecting neurohormonal stress and inflammatory activation.

Abstract

PURPOSE:

To validate the IABP-SHOCK II risk score in a Danish cohort and assess the association between the IABP-SHOCK II risk score and admission concentration of biomarkers reflecting neurohormonal - (Copeptin, Pro-atrial natriuretic peptide (proANP), Mid-regional pro-adrenomedullin (MRproADM)) and inflammatory (ST2) activation in patients with CS complicating ST segment elevation myocardial infarction (STEMI).

METHODS:

A total of 137 consecutive patients admitted with STEMI and CS at two tertiary heart centres were stratified according to the IABP-SHOCK II risk score (0-2; 3/4; 5-9), and had blood sampled upon admission.

RESULTS:

Plasma concentrations of Copeptin (median (pmol/L) score 0-2: 313; score 3/4: 682; score 5-9: 632 p < 0.0001), proANP (pmol/L) (1459; 2225; 2876 p = 0.0009) and MRproADM (nmol/L) (0.86; 1.2; 1.4 p = 0.04) were significantly associated with the risk score, whereas ST2 (ng/mL) was not (44; 60; 45 p = 0.23). The IABP-SHOCK II risk score predicted 30-day mortality (score 0-2: 22%; score 4/3: 51%; score 5-9: 72%, area under the curve (AUC): 0.73, plogrank < 0.0001), while the tested biomarkers did not (AUC: 0.51<plogrank < 0.57).

CONCLUSION:

Plasma concentrations of Copeptin, MRproADM and proANP were associated with the IABP-SHOCK II risk score in STEMI patients admitted with CS. The risk score predicted 30-day mortality, with no improvement in prediction when concentrations of the assessed biomarkers were added.

• Authors: Jakob Josiassen, Martin Frydland, Lene Holmvang, Ole Kristian Lerche Helgestad, Lisette Okkels Jensen, Jens Peter Goetze, Jacob Eifer Møller, Christian Hassager
• Journal: Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals (Biomarkers) Vol. 25 Issue 6 Pg. 506-512 (Sep 2020) ISSN: 1366-5804 [Electronic] England
• PMID: 32649233 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Glycopeptides
• IL1RL1 protein, human
• Interleukin-1 Receptor-Like 1 Protein
• NPPA protein, human
• Neurotransmitter Agents
• copeptins
• Adrenomedullin
• Atrial Natriuretic Factor

Topics

• Adrenomedullin (blood)
• Aged
• Atrial Natriuretic Factor (blood)
• Biomarkers (blood)
• Female
• Glycopeptides (blood)
• Humans
• Inflammation (blood, mortality, pathology)
• Interleukin-1 Receptor-Like 1 Protein (blood)
• Male
• Middle Aged
• Neurotransmitter Agents (blood)
• Percutaneous Coronary Intervention (adverse effects)
• ST Elevation Myocardial Infarction (blood, mortality, pathology)
• Shock, Cardiogenic (blood, mortality, pathology)