Key result
Out-of-hospital cardiac arrest in AMICS patients was associated with similar 30-day mortality (37% vs 38%) but significantly higher lactate, NGAL, and sTM, and lower sST2 levels.
Why the study?
AMICS with or without OHCA have pathophysiological differences and may represent distinct clinical entities, potentially reflecting differences in blood-borne biomarkers.
Do admission biomarker profiles differ between AMICS patients with and without out-of-hospital cardiac arrest?
Observational (n=86)
Do admission biomarker profiles differ between AMICS patients with and without out-of-hospital cardiac arrest?
AMICS patients with and without OHCA exhibit different biomarker profiles, supporting the concept that they may represent distinct clinical entities despite similar short-term mortality.
Answers are grounded in this paper and cite their sources.
Biomarker differences in AMICS ± OHCA are hypothesis-generating; leaves open distinct entities and tailored management.
BACKGROUND: Acute myocardial infarction complicated by cardiogenic shock (AMICS) with or without out-of-hospital cardiac arrest (OHCA) have some pathophysiological differences and could potentially be considered as two individual clinical entities. Thus, there may also be differences in terms of blood borne biomarkers. PURPOSE: To explore potential differences in concentrations of the biomarkers lactate, mid-regional proadrenomedullin (MRproADM), Copeptin, pro-atrial natriuretic peptide (proANP), Syndecan-1, soluble thrombomodulin (sTM), soluble suppression of tumorigenicity 2 (sST2) and neutrophil gelatinase-associated lipocalin (NGAL), in patients with AMICS with or without OHCA. METHOD: Patients admitted for acute coronary angiography due to suspected ST-elevation myocardial infarction were enrolled during a 1-year period. In the present study 86 patients with confirmed AMICS at admission were included. RESULTS: In the adjusted analysis OHCA patients had higher levels of lactate (p = 0.008), NGAL (p = 0.03) and sTM (p = 0.011) while the level of sST2 was lower (p = 0.029). There was little difference in 30-day mortality between the OHCA and non-OHCA groups (OHCA 37% vs. non-OHCA 38%). CONCLUSION: AMICS patients with or without OHCA had similar 30-day mortality but differed in terms of Lactate, NGAL, sTM and sST2 levels. These findings support that non-OHCA and OHCA patients with CS could be considered as two individual clinical entities.
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Thøgersen et al. (2021) conducted an observational in Acute myocardial infarction complicated by cardiogenic shock (AMICS) (n=86). Out-of-hospital cardiac arrest (OHCA) vs. Without out-of-hospital cardiac arrest (non-OHCA) was evaluated on 30-day mortality. Out-of-hospital cardiac arrest in AMICS patients was associated with similar 30-day mortality (37% vs 38%) but significantly higher lactate, NGAL, and sTM, and lower sST2 levels.
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