Combined Measurement of Soluble ST2 and Amino-Terminal Pro-B-Type Natriuretic Peptide Provides Early Assessment of Severity in Cardiogenic Shock Complicating Acute Coronary Syndrome

TOLPPANEN, H., R.L. MERCEDES, J. LASSUS, M. SADOUNE, E. GAYAT, K. PULKKI, M. ARRIGO, E. KRASTINOVA, A. SIONIS, J. PARISSIS, Jindřich ŠPINAR, J. JANUZZI, V.P. HARJOLA and A. MEBAZAA. Combined Measurement of Soluble ST2 and Amino-Terminal Pro-B-Type Natriuretic Peptide Provides Early Assessment of Severity in Cardiogenic Shock Complicating Acute Coronary Syndrome. Critical Care Medicine. Philadelphia: Lippincott Williams & Wilkins, 2017, vol. 45, No 7, p. "E666"-"E673", 8 pp. ISSN 0090-3493. Available from: https://dx.doi.org/10.1097/CCM.0000000000002336.

Basic information

Original name

Combined Measurement of Soluble ST2 and Amino-Terminal Pro-B-Type Natriuretic Peptide Provides Early Assessment of Severity in Cardiogenic Shock Complicating Acute Coronary Syndrome

Authors

TOLPPANEN, H., R.L. MERCEDES, J. LASSUS, M. SADOUNE, E. GAYAT, K. PULKKI, M. ARRIGO, E. KRASTINOVA, A. SIONIS, J. PARISSIS, Jindřich ŠPINAR, J. JANUZZI, V.P. HARJOLA and A. MEBAZAA

Edition

Critical Care Medicine, Philadelphia, Lippincott Williams & Wilkins, 2017, 0090-3493

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Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30218 General and internal medicine

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 6.630

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1097/CCM.0000000000002336

UT WoS

000403475400005

Keywords in English

amino-terminal pro-B-type natriuretic peptide; biomarkers; cardiogenic shock; prognosis; ST2

Tags

EL OK

Tags

International impact, Reviewed

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Abstract

V originále

Objectives: Mortality in cardiogenic shock complicating acute coronary syndrome is high, and objective risk stratification is needed for rational use of advanced therapies such as mechanical circulatory support. Traditionally, clinical variables have been used to judge risk in cardiogenic shock. The aim of this study was to assess the added value of serial measurement of soluble ST2 and amino-terminal pro-B-type natriuretic peptide to clinical parameters for risk stratification in cardiogenic shock. Design: CardShock (www.clinicaltrials.gov NCT01374867) is a prospective European multinational study of cardiogenic shock. The main study introduced CardShock risk score, which is calculated from seven clinical variables at baseline, and was associated with short-term mortality. Setting: Nine tertiary care university hospitals. Patients: Patients with cardiogenic shock caused by acute coronary syndrome (n=145). Interventions: In this substudy, plasma samples from the study patients were analyzed at eight time points during the ICU or cardiac care unit stay. Additional prognostic value of the biomarkers was assessed with incremental discrimination improvement. Measurements and Main Results: The combination of soluble ST2 and amino-terminal pro-B-type natriuretic peptide showed excellent discrimination for 30-day mortality (area under the curve, 0.77 at 12 hr up to 0.93 at 5-10 d after cardiogenic shock onset). At 12 hours, patients with both biomarkers elevated (soluble ST2, >= 500 ng/mL and amino-terminal pro-B-type natriuretic peptide, >= 4,500 ng/L) had higher 30-day mortality (79%) compared to those with one or neither biomarkers elevated (31% or 10%, respectively; p < 0.001). Combined measurement of soluble ST2 and amino-terminal pro-B-type natriuretic peptide at 12 hours added value to CardShock risk score, correctly reclassifying 11% of patients. Conclusions: The combination of results for soluble ST2 and amino-terminal pro-B-type natriuretic peptide provides early risk assessment beyond clinical variables in patients with acute coronary syndrome-related cardiogenic shock and may help therapeutic decision making in these patients.