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The admission level of CRP during cardiogenic shock is a strong independent risk marker of mortality.
Roubille, François; Cherbi, Miloud; Kalmanovich, Eran; Delbaere, Quentin; Bonnefoy-Cudraz, Eric; Puymirat, Etienne; Schurtz, Guillaume; Gerbaud, Edouard; Bonello, Laurent; Lim, Pascal; Leurent, Guillaume; Roubille, Camille; Delmas, Clément.
Affiliation
  • Roubille F; PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, CHU de Montpellier, Montpellier, France. francois.roubille@gmail.com.
  • Cherbi M; Intensive Care Unit, Cardiology Department, University Hospital of Montpellier, 34295, Montpellier, France. francois.roubille@gmail.com.
  • Kalmanovich E; Intensive Cardiac Care Unit, Rangueil University Hospital, 31059, Toulouse, France.
  • Delbaere Q; Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR-1048, National Institute of Health and Medical Research (INSERM), Toulouse, France.
  • Bonnefoy-Cudraz E; Cardiac Intensive Care Unit, Division of Cardiology, Shamir Medical Center, Affiliated to Tel Aviv University Faculty of Medicine, Tel Aviv, Israel.
  • Puymirat E; PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, CHU de Montpellier, Montpellier, France.
  • Schurtz G; Intensive Cardiac Care Unit, Lyon Brom University Hospital, Lyon, France.
  • Gerbaud E; Department of Cardiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, 75015, Paris, France.
  • Bonello L; Université de Paris, 75006, Paris, France.
  • Lim P; Urgences Et Soins Intensifs de Cardiologie, CHU Lille, University of Lille, Inserm U1167, 59000, Lille, France.
  • Leurent G; Intensive Cardiac Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, 5 Avenue de Magellan, 33604, Pessac, France.
  • Roubille C; Bordeaux Cardio-Thoracic Research Centre, U1045, Bordeaux University, Hôpital Xavier Arnozan, Avenue du Haut Lévêque, 33600, Pessac, France.
  • Delmas C; Aix-Marseille Université, 13385, Marseille, France.
Sci Rep ; 14(1): 16338, 2024 07 16.
Article in En | MEDLINE | ID: mdl-39014136
ABSTRACT
Inflammatory processes are involved not only in coronary artery disease but also in heart failure (HF). Cardiogenic shock (CS) and septic shock are classically distinct although intricate relationships are frequent in daily practice. The impact of admission inflammation in patients with CS is largely unknown. FRENSHOCK is a prospective registry including 772 CS patients from 49 centers. One-month and one-year mortalities were analyzed according to the level of C-reactive protein (CRP) at admission, adjusted on independent predictive factors. Within 406 patients included, 72.7% were male, and the mean age was 67.4 y ± 14.7. Four groups were defined, depending on the quartiles of CRP at admission. Q1 with a CRP < 8 mg/L, Q2 CRP was 8-28 mg/L, Q3 CRP was > 28-69 mg/L, and Q4 CRP was > 69 mg/L. The four groups did not differ regarding main baseline characteristics. However, group Q4 received more often antibiotics in 47.5%, norepinephrine in 66.3%, and needed more frequently respiratory support and renal replacement therapy. Whether at 1 month (Ptrend = 0.01) or 1 year (Ptrend < 0.01), a strong significant trend towards increased all-cause mortality was observed across CRP quartiles. Specifically, compared to the Q1 group, Q4 patients demonstrated a 2.2-fold higher mortality rate at 1-month (95% CI 1.23-3.97, p < 0.01), which persisted at 1-year, with a 2.14-fold increase in events (95% CI 1.43-3.22, p < 0.01). Admission CRP level is a strong independent predictor of mortality at 1 month and 1-year in CS. Specific approaches need to be developed to identify accurately patients in whom inflammatory processes are excessive and harmful, paving the way for innovative approaches in patients admitted for CS.NCT02703038.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Shock, Cardiogenic / C-Reactive Protein / Biomarkers Limits: Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: Sci Rep Year: 2024 Document type: Article Affiliation country:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Shock, Cardiogenic / C-Reactive Protein / Biomarkers Limits: Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: Sci Rep Year: 2024 Document type: Article Affiliation country: