Key result
Sepsis was associated with significantly increased plasma levels of sST2, suPAR, GDF-15, and H-FABP compared to cardiovascular disease entities and controls (p < 0.001).
Why the study?
In contrast to cardiovascular diseases, a detailed comparative analysis of novel cardiovascular biomarkers in sepsis was lacking.
How do plasma levels of novel cardiovascular biomarkers (sST2, GDF-15, suPAR, H-FABP) compare between patients with sepsis, heart failure, STEMI, and controls?
Observational (n=311)
How do plasma levels of novel cardiovascular biomarkers (sST2, GDF-15, suPAR, H-FABP) compare between patients with sepsis, heart failure, STEMI, and controls?
Novel cardiovascular biomarkers (sST2, GDF-15, suPAR, H-FABP) are significantly elevated in sepsis compared to heart failure and STEMI, suggesting their potential utility in assessing the cardiovascular component of sepsis.
Answers are grounded in this paper and cite their sources.
Biomarker elevations in sepsis exceed those in HF/STEMI; hypothesis-generating and requires prospective validation before any clinical use.
(1) Background: Sepsis still represents a major health care challenge, with mortality rates exceeding 25% in the western world. To further improve outcomes in this patient collective, new cardiovascular biomarkers present a promising opportunity as they target the paramount prognostic processes in sepsis: inflammation and ischemia. However, in contrast to cardiovascular diseases, a detailed analysis of novel biomarkers in sepsis is still lacking. (2) Objective: In this project, we aimed to perform a comparative analysis of biomarker levels in ischemic cardiovascular disease and sepsis. Analyzed markers comprised soluble suppression of tumorigenicity 2 (sST2; hemodynamics and inflammation), growth-differentiation factor 15 (GDF-15; injury, remodelling), soluble urokinase-type plasminogen activator receptor (suPAR; inflammation and remodeling) and heart-type fatty acid binding protein (H-FABP; myocardial ischemia). (3) Methods: In total, 311 patients were included in the study: 123 heart-failure (HF) patients, 60 patients with ST-segment elevation myocardial infarction (STEMI) and 53 sepsis patients. A total of 75 patients without coronary artery disease or signs of heart failure served as a control group. Plasma samples were analyzed by use of ELISA after informed consent. (4) Results: Patients with sepsis showed significantly increased plasma levels in all tested biomarkers compared to cardiovascular disease entities (sST2, suPAR, GDF-15: p < 0.001; H-FABP: compared to HF p < 0.001) and controls (sST2: 7.4-fold, suPAR: 3.4-fold, GDF-15: 6.5-fold and H-FABP: 15.3-fold increased plasma levels, p < 0.001). Moreover, in patients with sepsis, serum concentrations of sST2 and suPAR were significantly elevated in patients with HF and patients with STEMI (sST2: HF: 1.6-fold increase and STEMI: 2.5-fold increase, p < 0.001; suPAR: HF: 1.4-fold increase, p < 0.001 and STEMI: 1.4-fold increase, p < 0.01), whereas plasma levels of GDF-15 and H-FABP were markedly elevated in patients with STEMI only (GDF-15: 1.6-fold increase, H-FABP: 6.4-fold increase, p < 0.001). (5) Conclusions: All tested novel cardiac biomarkers showed significantly elevated levels in sepsis patients. Interestingly, a secretion pattern similar to STEMI was observed with regards to sST2 and HFABP. Thus, by providing an assessment tool especially covering the cardiovascular component of the disease, novel biomarkers offer a promising tool in sepsis patients.
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Jirak et al. (2022) conducted an observational in Sepsis and Cardiovascular Disease (n=311). Sepsis vs. Cardiovascular disease (heart failure, STEMI) and healthy controls was evaluated on Plasma levels of sST2, GDF-15, suPAR, and H-FABP (p=< 0.001). Sepsis was associated with significantly increased plasma levels of sST2, suPAR, GDF-15, and H-FABP compared to cardiovascular disease entities and controls (p < 0.001).
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