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The Capital Region of Denmark - a part of Copenhagen University Hospital

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

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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.

Original languageEnglish
Issue number6
Pages (from-to)506-512
Number of pages7
Publication statusPublished - Sep 2020

    Research areas

  • biomarkers, Cardiogenic shock, IABP-SHOCK II risk score, inflammation, myocardial infarction, neurohormonal activation, STEMI

ID: 60693400