TY - JOUR
T1 - Biomarker patterns in patients with cardiogenic shock versus septic shock
AU - Peters, Elma J.
AU - Frydland, Martin S.
AU - Hassager, Christian
AU - Bos, Lieuwe D.J.
AU - van Vught, Lonneke A.
AU - Cremer, Olaf L.
AU - Møller, Jacob E.
AU - van den Born, Bert Jan H.
AU - Vlaar, Alexander P.J.
AU - Henriques, Jose P.S.
PY - 2024/6
Y1 - 2024/6
N2 - Background: In cardiogenic shock (CS), contractile failure is often accompanied by a systemic inflammatory response syndrome. In contrast, many patients with septic shock (SS) develop cardiac dysfunction. A similar hemodynamic support strategy is often deployed in both syndromes but it is unclear whether this is justified based on profiles of biomarkers expressing neurohormonal activation and cardiovascular stress. Methods: In this prospective, multicenter cohort, 111 patients with acute myocardial infarction related CS were identified, and matched to patients with SS. Clinical parameters were collected and blood samples were obtained on day 1–3 of Intensive Care admission. Results: In this shock cohort comprising 222 patients, with a mean age of 61 (±13.5) years and of whom 161 (37 %) were male, we found that despite obvious clinical disparities on admission, mortality at 30-days did not differ (CS: 40.5 % vs. SS 43.1 %, p = 0.56). Overall, plasma concentrations of all biomarkers were higher in SS patients, with the largest difference on the first day. However, only in CS patients the biomarker concentrations were associated with mortality. Conclusion: In this prospective, multicenter cohort SS and CS patients showed similarities in baseline conditions and had similar mortality. However, several biomarkers only showed prognostic value in CS.
AB - Background: In cardiogenic shock (CS), contractile failure is often accompanied by a systemic inflammatory response syndrome. In contrast, many patients with septic shock (SS) develop cardiac dysfunction. A similar hemodynamic support strategy is often deployed in both syndromes but it is unclear whether this is justified based on profiles of biomarkers expressing neurohormonal activation and cardiovascular stress. Methods: In this prospective, multicenter cohort, 111 patients with acute myocardial infarction related CS were identified, and matched to patients with SS. Clinical parameters were collected and blood samples were obtained on day 1–3 of Intensive Care admission. Results: In this shock cohort comprising 222 patients, with a mean age of 61 (±13.5) years and of whom 161 (37 %) were male, we found that despite obvious clinical disparities on admission, mortality at 30-days did not differ (CS: 40.5 % vs. SS 43.1 %, p = 0.56). Overall, plasma concentrations of all biomarkers were higher in SS patients, with the largest difference on the first day. However, only in CS patients the biomarker concentrations were associated with mortality. Conclusion: In this prospective, multicenter cohort SS and CS patients showed similarities in baseline conditions and had similar mortality. However, several biomarkers only showed prognostic value in CS.
KW - Biomarkers
KW - Cardiogenic shock
KW - Mortality
KW - Septic shock
U2 - 10.1016/j.ijcha.2024.101424
DO - 10.1016/j.ijcha.2024.101424
M3 - Journal article
C2 - 38784047
AN - SCOPUS:85192777001
SN - 2352-9067
VL - 52
JO - IJC Heart & Vasculature
JF - IJC Heart & Vasculature
M1 - 101424
ER -