Soluble triggering receptor expressed on myeloid cells-1 is a marker of organ injuries in cardiogenic shock: results from the CardShock Study

Aims Optimal outcome after cardiogenic shock (CS) depends on a coordinated healing response in which both debris removal and extracellular matrix tissue repair play a crucial role. Excessive inflammation can perpetuate a vicious circle, positioning leucocytes as central protagonists and potential th...

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Autores: Kimmoun, A, Duarte, K, Harjola, VP, Tarvasmaki, T, Levy, B, Mebazaa, A, Gibot, S, Koniari, K, Voumvourakis, A, Karavidas, A, Parissis, J, Sans-Rosello, J, Vila, M, Duran-Cambra, A, Sionis, A, Parenica, J, Stipal, R, Ludka, O, Palsuva, M, Ganovska, E, Kubena, P, Spinar, J, Lindholm, MG, Hassager, C, Kober, L, Backlund, T, Lassus, J, Jurkko, R, Tolppanen, H, Nieminen, MS, Jarvinen, K, Nieminen, T, Pulkki, K, Soininen, L, Sund, R, Tierala, I, Tolonen, J, Varpula, M, Korva, T, Pietila, M, Pitkala, A, Marino, R, Di Somma, S, Metra, M, Bulgari, M, Lazzarini, V, Carubelli, V, Sousa, A, Silva-Cardoso, J, Sousa, C, Paiva, M, Rangel, I, Almeida, R, Pinho, T, Maciel, MJ, Banaszewski, M, Stepinska, J, Skrobisz, A, Goral, P, Zeymer, U, Thiele, H
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p4928
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4928
https://hal.univ-lorraine.fr/hal-03901020
Access Level:acceso abierto
Palabra clave:Biomarkers
STREM
Cardiogenic Shock
Outcome
Descripción
Sumario:Aims Optimal outcome after cardiogenic shock (CS) depends on a coordinated healing response in which both debris removal and extracellular matrix tissue repair play a crucial role. Excessive inflammation can perpetuate a vicious circle, positioning leucocytes as central protagonists and potential therapeutic targets. High levels of circulating Triggering Receptor Expressed on Myeloid cells-1 (TREM-1), were associated with death in acute myocardial infarction confirming excessive inflammation as determinant of bad outcome. The present study aims to describe the association of soluble TREM-1 with 90-day mortality and with various organ injuries in patients with CS. Methods and results This is a post-hoc study of CardShock, a prospective, multicenter study assessing the clinical presentation and management in patients with CS. At the time of this study, 87 patients had available plasma samples at either baseline, and/or 48 h and/or 96-120 h for soluble TREM-1 (sTREM-1) measurements. Plasma concentration of sTREM-1 was higher in 90-day non-survivors than survivors at baseline [median: 1392 IQR: (724-2128) vs. 621 (525-1233) pg/mL, p = 0.008), 48 h (p = 0.019) and 96-120 h (p = 0.029). The highest tertile of sTREM-1 at baseline (threshold: 1347 pg/mL) was associated with 90-day mortality with an unadjusted HR 3.08 CI 95% (1.48-6.42). sTREM-1 at baseline was not associated to hemodynamic parameters (heart rate, blood pressure, use of vasopressors or inotropes) but rather with organ injury markers: renal (estimated glomerular filtration rate, p = 0.0002), endothelial (bio-adrenomedullin, p = 0.018), myocardial (Suppression of Tumourigenicity 2, p = 0.002) or hepatic (bilirubin, p = 0.008). Conclusion In CS patients TREM-1 pathway is highly activated and gives an early prediction of vital organ injuries and outcome. [GRAPHICS] .

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