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Rigshospitalet - a part of Copenhagen University Hospital
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Plasma Concentration of Biomarkers Reflecting Endothelial Cell- and Glycocalyx Damage are Increased in Patients with Suspected St-Elevation Myocardial Infarction Complicated by Cardiogenic Shock

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  1. Acute Lung Injury in Critically Ill Patients: Actin-Scavenger Gelsolin Signals Prolonged Respiratory Failure

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Lactate is a Prognostic Factor in Patients Admitted with Suspected ST-Elevation Myocardial Infarction

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BACKGROUND: Mortality in ST-elevation myocardial infarction (STEMI)-patients developing cardiogenic shock (CS) during hospitalization is high. Catecholamines, ischemia, and inflammation (parameters present in CS) affect the endothelium. We hypothesized that plasma level of biomarkers reflecting endothelial damage would be associated with CS and mortality.

METHODS: In 96% of 1467 consecutive patients with suspected STEMI, biomarkers reflecting endothelial cell- (soluble thrombomodulin, sTM) and glycocalyx- (syndecan-1) damage were measured on admission. Patients were stratified by CS development or not. CS-Patients were substratified by CS on admission (admission-CS), CS developed in the catheterization laboratory (cath. lab.-CS), or late CS.

RESULTS: STEMI-patients with admission-CS (n = 85) and cath.lab.-CS (n = 25) had higher levels of sTM and syndecan-1 compared to no-CS patients (n = 1299). Late CS-patients (n = 58) had higher levels of sTM (median (25; 75 percentile) 8.8 (7.0; 11.6) vs. 7.4 (6.0; 9.0) ng/ml, p = 0.0004) but not Syndecan-1 (p = 0.26) compared to no-CS patients. sTM was, however, not independently associated with late CS development (OR (95% CI) 1.07 (0.99-1.16), p = 0.09). Patients with the highest level of sTM and syndecan-1 had the highest 30-day mortality (Plogrank<0.0001). However, neither sTM nor Syndecan-1 was independently associated with 30-day mortality (HR (95% CI) sTM: 1.06 (0.996 - 1.12), p = 0.07; Syndecan-1: 1.04 (0.99 - 1.08), p = 0.12).

CONCLUSION: Patients with suspected STEMI-patients and admission-CS/cath.lab.-CS had elevated admission levels of sTM and Syndecan-1 compared to no CS-patients. Patients developing late CS had higher sTM plasma concentration compared to patients without shock. However, the biomarker levels were not independently associated with late CS and mortality.

Original languageEnglish
JournalShock
Volume50
Issue number5
Pages (from-to)538-544
ISSN1073-2322
DOIs
Publication statusPublished - 2018

    Research areas

  • Journal Article

ID: 52776457