Abstract
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.
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.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 101424 |
| Tidsskrift | IJC Heart and Vasculature |
| Vol/bind | 52 |
| Antal sider | 8 |
| ISSN | 2352-9067 |
| DOI | |
| Status | Udgivet - 2024 |
| Udgivet eksternt | Ja |
Bibliografisk note
Funding Information:This research was performed within the framework of the Center for Translational Molecular Medicine (CTMM) (www.ctmm.nl), project Molecular Diagnosis and Risk Stratification of Sepsis (Grant 04I-201). Members of MARS consortium are:, Departments of Intensive Care Medicine, Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands: Friso M. de Beer, MD, Lieuwe D. J. Bos, PhD, Gerie J. Glas, MD, Roosmarijn T. M. van Hooijdonk, MD, Janneke Horn, MD, Laura R. A. Schouten, MD, Marleen Straat, MD, Marcus J. Schultz, MD, Luuk Wieske, MD, Esther Witteveen, MD. Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands: Arie J. Hoogendijk, PhD, Mischa A. Huson, MD, Tom van der Poll. MD, Brendon P. Scicluna, PhD, Lonneke A. van Vught, MD, Maryse A. Wiewel, MD. Department of Medical Microbiology, Department of Intensive Care Medicine, and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Peter M.C. Klein Klouwenberg, MD, David S.Y. Ong, MD; Department of Intensive Care Medicine and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Jos F. Frencken, MD, Maria E. Koster-Brouwer, MSc, Kirsten van de Groep, MD, Diana M. Verboom, MD. This work was supported by The Danish Heart Foundation, Denmark under grant no. R107-A6670; and Copenhagen University, Copenhagen, Denmark under grant no.: 373032.
Funding Information:
This research was performed within the framework of the Center for Translational Molecular Medicine (CTMM) ( www.ctmm.nl ), project Molecular Diagnosis and Risk Stratification of Sepsis (Grant 04I-201). Members of MARS consortium are:
Funding Information:
This work was supported by The Danish Heart Foundation under grant no. R107-A6670 ; and Copenhagen University under grant no.: 373032 .
Publisher Copyright:
© 2024