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

当前位置： X-MOL 学术 › Biomarkers › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Mortality in cardiogenic shock is stronger associated to clinical factors than contemporary biomarkers reflecting neurohormonal stress and inflammatory activation.
Biomarkers ( IF 2.6 ) Pub Date : 2020-07-20 , DOI: 10.1080/1354750x.2020.1795265
Jakob Josiassen ₁ , Martin Frydland ₁ , Lene Holmvang _{1,

2} , Ole Kristian Lerche Helgestad ₃ , Lisette Okkels Jensen ₃ , Jens Peter Goetze ₄ , Jacob Eifer Møller _{1,

3} , Christian Hassager _{1,

2}

Affiliation

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.

中文翻译：

心源性休克中的死亡率与临床因素相比，比反映神经激素压力和炎症激活的当代生物标志物更强。

目的

要验证丹麦队列中的IABP-SHOCK II风险评分，并评估IABP-SHOCK II风险评分与反映神经激素的生物标志物的入院浓度之间的关联-（肽素，心房利钠肽前体（proANP），中部区域CS合并ST段抬高型心肌梗死（STEMI）的CS患者中肾上腺髓质素（MRproADM）和炎症（ST2）激活。

方法

根据IABP-SHOCK II风险评分（0–2; 3/4; 5–9）对在两个三级心脏中心接受STEMI和CS的连续137例患者进行分层，并在入院时进行血液采样。

结果

血浆Copeptin浓度（中位数（pmol / L）得分0–2：313;得分3/4：682;得分5–9：632 p <0.0001），proANP（pmol / L）（1459; 2225; 2876 p = 0.0009）和MRproADM（nmol / L）（0.86; 1.2; 1.4 p = 0.04）与风险评分显着相关，而ST2（ng / mL）与风险分数没有显着相关（44; 60; 45 p = 0.23）。IABP-SHOCK II风险评分可预测30天死亡率（评分0–2：22％；评分4/3：51％；评分5–9：72％，曲线下面积（AUC）：0.73，p logrank < 0.0001），而测试的生物标志物则没有（AUC：0.51 < p logrank <0.57）。