J 2021

Kinetics of procalcitonin, C-reactive protein and interleukin-6 in cardiogenic shock – Insights from the CardShock study

KATAJA, Anu, Tuukka TARVASMÄKI, Johan LASSUS, Alessandro SIONIS, Alexandre MEBAZAA et. al.

Basic information

Original name

Kinetics of procalcitonin, C-reactive protein and interleukin-6 in cardiogenic shock – Insights from the CardShock study

Authors

KATAJA, Anu (246 Finland, guarantor), Tuukka TARVASMÄKI (246 Finland), Johan LASSUS (246 Finland), Alessandro SIONIS (724 Spain), Alexandre MEBAZAA (250 France), Kari PULKKI (246 Finland), Marek BANASZEWSKI (616 Poland), Valentina CARUBELLI (380 Italy), Mari HONGISTO (246 Finland), Ewa JANKOWSKA (616 Poland), Raija JURKKO (246 Finland), Toni JÄNTTI (246 Finland), Monika KASZTURA (616 Poland), John PARISSIS (300 Greece), Tuija SABELL (246 Finland), Jose SILVA-CARDOSO (620 Portugal), Jindřich ŠPINAR (203 Czech Republic, belonging to the institution), Heli TOLPPANEN (246 Finland) and Veli-Pekka HARJOLA (246 Finland)

Edition

International Journal of Cardiology, Clare, Elsevier, 2021, 0167-5273

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 4.039

RIV identification code

RIV/00216224:14110/21:00120857

Organization unit

Faculty of Medicine

UT WoS

000612679700043

Keywords in English

Cardiogenic shock; Inflammation; Procalcitonin; Interleukin 6; C-reactive protein

Tags

Tags

International impact, Reviewed
Změněno: 29/6/2021 11:45, Mgr. Tereza Miškechová

Abstract

V originále

Background Inflammatory responses play an important role in the pathophysiology of cardiogenic shock (CS). The aim of this study was to investigate the kinetics of procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) in CS and to assess their relation to clinical presentation, other biochemical variables, and prognosis. Methods Levels of PCT, CRP and IL-6 were analyzed in serial plasma samples (0−120 h) from 183 patients in the CardShock study. The study population was dichotomized by PCT max ≥ and < 0.5 μg/L, and IL-6 and CRP max above/below median. Results PCT peaked already at 24 h [median PCT max 0.71 μg/L (IQR 0.24–3.4)], whereas CRP peaked later between 48 and 72 h [median CRP max 137 mg/L (59–247)]. PCT levels were significantly higher among non-survivors compared with survivors from 12 h on, as were CRP levels from 24 h on ( p < 0.001). PCT max ≥ 0.5 μg/L (60% of patients) was associated with clinical signs of systemic hypoperfusion, cardiac and renal dysfunction, acidosis, and higher levels of blood lactate, IL-6, growth-differentiation factor 15 (GDF-15), and CRP max. Similarly, IL-6 > median was associated with clinical signs and biochemical findings of systemic hypoperfusion. PCT max ≥ 0.5 μg/L and IL-6 > median were associated with increased 90-day mortality (50% vs. 30% and 57% vs. 22%, respectively; p < 0.01 for both), while CRP max showed no prognostic significance. The association of inflammatory markers with clinical infections was modest. Conclusions Inflammatory markers are highly related to signs of systemic hypoperfusion in CS. Moreover, high PCT and IL-6 levels are associated with poor prognosis.